Article type
Abstract
Background: There is a need to increase the quality of evidence synthesis of economic studies related to support health technology assessment (HTA) and clinical practice guidelines development. Standardizing good practices in conducting economic evaluation studies is important for producing reliable information to maintain an equitable and sustainable healthcare system.
Objectives: To describe the process and activities to update the Brazilian guidelines for health economic evaluation to support the HTA process in the public health system. The updated guideline presents the first compendium of recommendations to support health economic evaluations with focus on the Brazilian public health system.
Methods: The recommendations were developed by a working group composed by methodologists, researchers, professors and specialists in CPG development, evidence synthesis, and health economic evaluation through several actions: a) draft of initial recommendations based on theoretical chapters of the Brazilian guideline, international guidelines and seminal manuscripts and books; b) virtual workshops and panels with researchers and specialists to support and improve each recommendation through their inputs. The final version of each recommendation is based on the consensus between specialists. The rationale for each final decision was included in the text.
Results: The consensus includes 77 recommendations within the following topics: problem characterization, type of economic analysis choice, case base definition (perspective, population, intervention and comparators, time horizon, discount rate, health outcomes, costing, effectiveness), modeling, and uncertainty and sensitivity analysis. 23 recommendations were specific for evidence synthesis related to clinical effectiveness (11), health utility values (12). Recommendations were made to create a hierarchy of ways to obtain data of health utility values to enhance evidence synthesis and transparency during decision-making process.
Conclusions: This guideline creates unified national standards for health economic analysis, that will guide recommendations for both clinical practice guidelines and HTA in the decision-making process in the Brazilian public health system. This set of recommendations is not obligatory, but it is meant to serve as a guide and lead to the development of better and more transparent economic models in the country.
Objectives: To describe the process and activities to update the Brazilian guidelines for health economic evaluation to support the HTA process in the public health system. The updated guideline presents the first compendium of recommendations to support health economic evaluations with focus on the Brazilian public health system.
Methods: The recommendations were developed by a working group composed by methodologists, researchers, professors and specialists in CPG development, evidence synthesis, and health economic evaluation through several actions: a) draft of initial recommendations based on theoretical chapters of the Brazilian guideline, international guidelines and seminal manuscripts and books; b) virtual workshops and panels with researchers and specialists to support and improve each recommendation through their inputs. The final version of each recommendation is based on the consensus between specialists. The rationale for each final decision was included in the text.
Results: The consensus includes 77 recommendations within the following topics: problem characterization, type of economic analysis choice, case base definition (perspective, population, intervention and comparators, time horizon, discount rate, health outcomes, costing, effectiveness), modeling, and uncertainty and sensitivity analysis. 23 recommendations were specific for evidence synthesis related to clinical effectiveness (11), health utility values (12). Recommendations were made to create a hierarchy of ways to obtain data of health utility values to enhance evidence synthesis and transparency during decision-making process.
Conclusions: This guideline creates unified national standards for health economic analysis, that will guide recommendations for both clinical practice guidelines and HTA in the decision-making process in the Brazilian public health system. This set of recommendations is not obligatory, but it is meant to serve as a guide and lead to the development of better and more transparent economic models in the country.