Use of quality checklists and need for disease-specific guidance in economic evaluations: a meta-review

Abstract

Economic evaluations have become an essential part of reimbursement decisions in a wide range of countries. To ensure high quality, a variety of checklists with different purposes have been developed and implemented enabling assessment of these evaluations. Three of these checklists are most frequently used and are recommended by the Cochrane Handbook for Systematic Reviews for critical appraisal (Drummond, CHEC and Philips). Every checklist is developed with a different purpose having, for example, a focus on reporting or conducting and on modeling or trial-based evaluations. This review outlines the heterogeneity in choice and implementation of these quality checklists in an incorrect manner. This ultimately results in under- and even possibly overestimation of quality of included economic evaluations. More guidance in selecting correct checklists suiting the purpose of the quality check is therefore of utmost importance. Moreover, it appears that current checklists are lacking detailed disease-specific guidance resulting in models not correctly reflecting disease progression. Therefore, outcomes indicate that the problem of the wide variability of methodological choices is prevalent in some other disease areas too, regardless of the availability of quality checklists. More international collaboration should therefore be initiated in developing and publishing standardized and open source disease-specific reference models to overcome this problem.

Keywords:

• checklists
• economic evaluations
• modeling
• quality
• reference model

Financial & competing interests disclosure

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.

No writing assistance was utilized in the production of this manuscript.

Key issues

• No guidance is available regarding use of quality checklists in reviewing economic evaluations.

• Unsuited checklists are used to quality appraise economic evaluations.

• Widely varying modeling methods have been used within various disease areas.

• A few authors have concluded that standardized disease-specific methods are needed to overcome heterogeneity of modeling methods.

• Standardized and open source models are needed to overcome such issues and increase validity and transparency.

• Such models can be implemented within several countries and adapted to country-specific needs.

• Increased guidance in the use of checklists and standard models will result in more efficient appraisal systems within different countries.