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Abstract
Background: the Chilean process for the elaboration of Clinical Practice Guidelines (CPG) uses the GRADE approach in order to develop evidence-based recommendations. One dimension of this system is the evidence of cost effectiveness. However, it is not always necessary to generate this type of evidence, since in certain cases there is no uncertainty regarding the cost-effectiveness of technologies that are evaluated. For this reason, it is proposed that a method be developed to assess what questions require this type of evidence.
Objectives: to describe the prioritizing questions in the method to determine for which CPGs evidence of economic evaluations would be relevant.
Methods: we carried out a review of international experience for prioritization methods for economic evaluation evidence for CPGs. Afterwards, we agreed a prioritization proposal and validated it with the unit in charge of preparing CPGs. Finally, this method of prioritization was applied in the committees of experts who develop guidelines.
Results: we found three references regarding the prioritization of economic evaluations for CPG development, Knies (2018), NICE-England and IETS-Colombia. All of them, recommend that cost-effectiveness evidence should be incorporated in CPGs.
The proposed method is based on the recommendations of NICE-England and IETS-Colombia. The criteria to include cost-effectiveness evidence are: high variability in clinical practice; high uncertainty regarding cost-effectiveness in the national context; and that the variation in clinical practice implies relevant health benefits or a high impact in terms of costs. Then, based on these criteria, interventions are categorized into: high, medium, low priority and non-relevant questions to include evidence of cost effectiveness.
Conclusions: the methodological proposal improves the prioritization of the search for economic evaluations. Therefore, it increases the efficiency of the human resources that generate this type of evidence.
Patient or healthcare consumer involvement: this method of prioritization allows the delivery of relevant evidence of cost-effectiveness for clinical experts; which will benefit patients.
Objectives: to describe the prioritizing questions in the method to determine for which CPGs evidence of economic evaluations would be relevant.
Methods: we carried out a review of international experience for prioritization methods for economic evaluation evidence for CPGs. Afterwards, we agreed a prioritization proposal and validated it with the unit in charge of preparing CPGs. Finally, this method of prioritization was applied in the committees of experts who develop guidelines.
Results: we found three references regarding the prioritization of economic evaluations for CPG development, Knies (2018), NICE-England and IETS-Colombia. All of them, recommend that cost-effectiveness evidence should be incorporated in CPGs.
The proposed method is based on the recommendations of NICE-England and IETS-Colombia. The criteria to include cost-effectiveness evidence are: high variability in clinical practice; high uncertainty regarding cost-effectiveness in the national context; and that the variation in clinical practice implies relevant health benefits or a high impact in terms of costs. Then, based on these criteria, interventions are categorized into: high, medium, low priority and non-relevant questions to include evidence of cost effectiveness.
Conclusions: the methodological proposal improves the prioritization of the search for economic evaluations. Therefore, it increases the efficiency of the human resources that generate this type of evidence.
Patient or healthcare consumer involvement: this method of prioritization allows the delivery of relevant evidence of cost-effectiveness for clinical experts; which will benefit patients.
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