Tool of transferability: application on studies of cost-effectiveness

Article type
Authors
Velásquez M1, Vallejos C1, Bustos L1, De la Puente C1, Zaror C1
1Universidad de La Frontera, Chile
Abstract
Background:
Studies of cost-effectiveness (CE) are conditioned by the local context, with different results between countries. Variables such as incidence of disease, severity, availability of resources, clinical practice variations, and relative prices, could modify the results. An economic evaluation (EE) is generalizable when its results can be applied without adjustment, and it is transferable if the results can be adapted to apply in other realities. There are several ways and methods to assess transferability.

Objectives:
To apply a tool of transferability in CE studies obtained from a systematic review directed to answer questions about health technology assessment (HTA) in Chile.

Methods:
A systematic review of the literature on transferability methods in CE studies was carried out. Alongside this resource a tool of transferability was developed and implemented, which was compared with CE criteria defined by the Chilean Ministry of Health.

Results:
The transferability tool was developed from a study (Goeree 2011) selected in a systematic review, adopting the transferability criteria of Welte 2004 and including validation criteria of Drummond 2005. This tool was applied to 27 CE studies selected to respond to the evaluation of six health technologies in Chile; 68% of the articles were highly transferable. Compared with the “Chilean Guide to use CE evidence”, the correspondence was high.

Conclusions:
It is possible to transfer CE results and to avoid performing new CE studies. In the scope of HTA it is necessary when a rapid response is required or a new study is very expensive. It is noted that the main barrier to transferability is the wide variability of costs and willingness to pay in different countries.