Perspectives in prospective comparative economic evaluations: a systematic review

ABSTRACT

Introduction

Depending on countries and health systems, medico-economic assessment guidelines recommend to adopt one or several perspectives. We conducted a systematic literature review in order to assess the fit between the country guidelines and the perspectives announced in the published studies.

Areas covered

Searches were carried out within the Medline electronic database for records published between 1 January 2000 and 31 August 2020. Only studies from countries in which guidelines recommending a perspective to adopt were available online were selected.

Expert opinion

A total of 398 studies were included. Among those studies, 212 (54.9%) adopted as a main perspective a public payer perspective, 141 (36.5%) a societal perspective, 25 (6.5%) a hospital perspective, and 8 (2.1%) a patient perspective. Recommendations in terms of perspective were followed by 267 (67.1%) studies, mainly from Canada, the UK, and the Netherlands. Two thirds of the perspectives chosen in studies were in line with the recommendations. While the choice of a perspective does not question the quality of the studies published, it raises the question of the relevance of the perspectives that must be adapted to the question asked, the pathology studied, and the feasibility of the studies.

KEYWORDS:

• Economic evaluation
• guidelines
• perspective
• recommendations
• systematic literature review

Article highlights

• Choosing a perspective in economic evaluations is an important issue,

• There is a strong heterogeneity despite the numerous guidelines, and there is a need for harmonization,

• While the choice of a perspective does not question the quality of the studies published, it also raises the question of the relevance of the perspectives that must be adapted to the question asked, the pathology studied, and the feasibility of the studies.

Acknowledgments

The authors thank Dr Hélène Boyer and Dr Verena Landel for help in manuscript preparation.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers of this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.