, Volume 35, Issue 3, pp 347–362 | Cite as

Valuing Meta-Health Effects for Use in Economic Evaluations to Inform Reimbursement Decisions: A Review of the Evidence

  • Richard De Abreu Lourenco
  • Marion Haas
  • Jane Hall
  • Rosalie Viney
Systematic Review



This review explores the evidence from the literature regarding how meta-health effects (effects other than health resulting from the consumption of health care) are valued for use in economic evaluations.


A systematic review of the published literature (the EMBASE, MEDLINE, PsycINFO, CINAHL, EconLit and SocINDEX databases were searched for publications in March 2016, plus manual searching) investigated the associations between study methods and the resulting values for meta-health effects estimated for use in economic evaluations. The review considered which meta-health effects were being valued and how this differed by evaluation approach, intervention investigated, source of funds and year of publication. Detailed reasons for differences observed between values for comparable meta-health effects were explored, accounting for the method of valuation.


The search of the literature revealed 71 studies of interest; 35% involved drug interventions, with convenience, information and process of care the three meta-health effects most often investigated. Key associations with the meta-health effects were the evaluation method, the intervention, and the source of funds. Relative values for meta-health effects ranged from 0.9% to 68% of the overall value reported in a study. For a given meta-health effect, the magnitude of the effect evaluated and how the meta-health effect was described and framed relative to overall health explained the differences in relative values.


Evidence from the literature shows variability in how meta-health effects are being measured for use in economic evaluations. Understanding the sources of that variability is important if decision makers are to have confidence in how meta-health effects are valued.


Economic Evaluation Assisted Reproductive Technology Contingent Valuation Valuation Method Conjoint Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors acknowledge the contribution of Liz Chinchen in conducting the initial search of the literature and assisting with refinement of the search criteria. They also acknowledge the contributions made by the anonymous reviewers at Pharmacoeconomics in refining this article.

Compliance with Ethical Standards

This research was completed as part of a Ph.D. programme for Richard De Abreu Lourenco, who was a recipient of the University of Technology Sydney Business School Ph.D. Scholarship.


No funding was received specifically for the conduct of this research.

Conflict of interest

Richard De Abreu Lourenco has no conflicts of interest to declare. Professor Marion Haas, Professor Jane Hall and Professor Rosalie Viney have no conflicts of interest to declare. There was no requirement for this study to undergo review by a Human Research Ethics Committee.

Author contributions

RAL was responsible for the design of this research, review of the literature searches, data abstraction and analysis, and manuscript preparation. Professors MH, JH and RV were involved in defining the parameters of the research, resolving questions regarding study inclusion, interpretation of the analysis, and manuscript preparation. All authors take responsibility for the final version of this article.

Supplementary material

40273_2016_470_MOESM1_ESM.docx (11 kb)
Supplementary material 1 (DOCX 11 kb)


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Centre for Health Economics Research and EvaluationUniversity of Technology SydneySydneyAustralia

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