Understanding barriers and approaches to communicating health economic evidence: systematic review and needs assessment

Article type
Authors
Sullivan S1, Akbar Z2, Bell C3, Sabharwal M4
1University of Ottawa, Canada
2McMaster University, Canada
3University of Toronto, Canada
4pan-Canadian Oncology Drug Review, Canada
Abstract
Background: Economic evaluations are a key component of evidence-informed decision-making. However, gaps exist in understanding economic evaluations. Improved methods of communicating economic evaluations may increase understanding of health economic evidence and enhance its role in policy decision-making.

Objectives: To identify barriers and requirements for communicating health economic evidence to a non-technical audience.

Methods: (1) A systematic review was conducted identifying ways of using economic evidence; barriers to using economic evidence; comprehension of economic evidence and methods of communicating economic evidence. All studies with a defined methodology and reporting on methods, interventions or tools conveying economic evidence were included. Cochrane systematic review methodology was followed and risk of bias assessed. (2) A needs assessment was also conducted using a small purposive sample of the general public with exposure to economic evidence and health policy decision-making. Key informant interviews (N = 7) identified challenges in understanding health economic evidence.

Results: Twenty-two studies were included. Most studies were surveys and interviews (semi-structured or key informant). Common study limitations were selection and detection bias. Despite heterogeneity of studies, conclusions were consistent across studies. Economic evidence was used to determine public health costs and resource allocation; support drug funding decisions; and inform cost-effectiveness analyses. Common barriers to using economic evidence were technical language and challenges transferring to the local context. Comprehension of economic evidence was low among all audiences. Improving communication should focus on clearly presenting cost-effectiveness analyses with the appropriate amount and level of detail. These findings were corroborated by the needs assessment. Key informants confirmed they have challenges understanding economic evaluations and indicated economic information should always be presented in the simplest, non-technicalmanner possible.

Conclusion: Effective communication of economic evidence requires concepts to be simplified and contextual examples provided. Findings will inform development of tools that enhance communication and understanding of economic evaluations.