Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie (INSPECT-Lb), Beirut, Lebanon.
Int J Technol Assess Health Care. 2021 Dec 21;38(1):e1. doi: 10.1017/S0266462321000659.
To systematically identify the latest versions of official economic evaluation guidelines (EEGs) in low- and middle-income countries (LMICs) and explore similarities and differences in their content.
We conducted a systematic search in MEDLINE (Ovid), PubMed, EconLit, Embase (Ovid), the Cochrane Library, and the gray literature. Using a predefined checklist, we extracted the key features of economic evaluation and the general characteristics of EEGs. We conducted a comparative analysis, including a summary of similarities and differences across EEGs.
Thirteen EEGs were identified, three pertaining to lower-middle-income countries (Bhutan, Egypt, and Indonesia), nine to upper-middle-income countries (Brazil, China, Colombia, Cuba, Malaysia, Mexico, Russian Federation, South Africa, and Thailand), in addition to Mercosur, and none to low-income countries. The majority (n = 12) considered cost-utility analysis and health-related quality-of-life outcome. Half of the EEGs recommended the societal perspective, whereas the other half recommended the healthcare perspective. Equity considerations were required in ten EEGs. Most EEGs (n = 11) required the incremental cost-effectiveness ratio and recommended sensitivity analysis, as well as the presentation of a budget impact analysis (n = 10). Seven of the identified EEGs were mandatory for pharmacoeconomics submission. Methodological gaps, contradictions, and heterogeneity in terminologies used were identified within the guidelines.
As the importance of health technology assessment is increasing in LMICs, this systematic review could help researchers explore key aspects of existing EEGs in LMICs and explore differences among them. It could also support international organizations in guiding LMICs to develop their own EEGs and improve the methodological framework of existing ones.
系统识别中低收入国家（LMICs）最新版本的官方经济评估指南（EEGs），并探讨其内容的异同。
我们在 MEDLINE（Ovid）、PubMed、EconLit、Embase（Ovid）、Cochrane 图书馆和灰色文献中进行了系统搜索。使用预定义的清单，我们提取了经济评估的关键特征和 EEG 的一般特征。我们进行了比较分析，包括对 EEG 之间异同的总结。
确定了 13 项 EEG，其中 3 项涉及中低收入国家（不丹、埃及和印度尼西亚），9 项涉及中高收入国家（巴西、中国、哥伦比亚、古巴、马来西亚、墨西哥、俄罗斯联邦、南非和泰国），以及 Mercosur，没有一个是低收入国家。大多数（n=12）考虑成本效用分析和健康相关生活质量结果。一半的 EEG 建议采用社会视角，而另一半则建议采用医疗保健视角。在 10 项 EEG 中需要考虑公平性。大多数 EEG（n=11）需要增量成本效益比，并建议进行敏感性分析，以及呈现预算影响分析（n=10）。11 项 EEG 中有 7 项是药物经济学提交的强制性要求。在指南中发现了方法上的差距、矛盾和术语使用的异质性。
随着健康技术评估在 LMICs 中的重要性不断增加，这项系统评价可以帮助研究人员探索 LMICs 中现有 EEG 的关键方面，并探讨它们之间的差异。它还可以支持国际组织指导 LMICs 制定自己的 EEG，并改进现有 EEG 的方法框架。
