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Can economic evaluations be made more transferable?

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Abstract

Several commentators have identified the lack of generalisability and transferability of economic evaluation results. The aims of this study were: (a) to develop a checklist to assess the level of generalisability and transferability of economic evaluations; (b) to assess the generalisability and transferability of economic evaluations between the UK and France using the checklist; (c) to identify reasons for any lack of transferability and generalisability; (d) to assess how the transferability and generalisability of economic evaluations can be improved; and (e) to outline ways in which databases of economic evaluations and journals can assist in this area. The checklist was developed using previous work and the templates of the NHS EED and CODECS databases. A sub-checklist of essential items was then derived. Validation of the two checklists was undertaken with Health Economists participating in the EURONHEED project. Economic evaluations involving the UK and France were then located and assessed using the checklist. A summary score for each study was calculated based on the percentage of correctly reported (applicable) points, and the results in the empirical analysis compared to identify differences. The extended checklist includes 42 items, and the sub-checklist 16 items. Twenty-five economic evaluations met the inclusion criteria for the empirical analysis. In the extended checklist the mean score was 66.9±13.6%. The results for the sub-checklist were very similar. The analysis revealed that costing, assessments of generalisability by the author(s), assessment of data variability, discounting, study population, and the reporting of effectiveness are areas that need more attention. Differences in cost-effectiveness results are often accounted for by price or organisational differences. The developed checklists are useful in assessing the generalisability and transferability of economic evaluations. In order to improve the generalisability and transferability of economic evaluations authors need to be more explicit and detailed in describing and reporting their studies. If they are to provide added value to their users, international databases of economic evaluations should systematically assess the generalisability and transferability of studies. Further research is in progress on producing a weighted version of the checklist.

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Author notes

  1. John Nixon

    Present address: Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK

Authors and Affiliations

  1. Collège des Économistes de la Santé, Paris, France

    Stephanie Boulenger, Philippe Ulmann & Gerard de Pouvourville

  2. University of York, UK

    John Nixon, Michael Drummond & Stephen Rice

Authors
  1. Stephanie Boulenger
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  2. John Nixon
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  3. Michael Drummond
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  4. Philippe Ulmann
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  5. Stephen Rice
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  6. Gerard de Pouvourville
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Corresponding author

Correspondence to John Nixon.

Appendix

Appendix

A detailed comparison of the studies included in this analysis is presented in tabular form in Table 4.

Table 4 Converted results, sources of difference and checklist scores (MS multi-country study with cost valuations for both the UK and France, MS1-UK, MS1-F multi-country economic evaluation in which the costing was performed for only one country, either the UK or France, MS-P multi-country study for which costing was based on pooled data from a number of countries that included both the UK and France, SC-UK, SC-F independent study carried out in either the UK or France but on the same health technology, QALY quality-adjusted life-years, NSAIDs nonsteroidal anti-inflammatory drugs, NG not given)
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Boulenger, S., Nixon, J., Drummond, M. et al. Can economic evaluations be made more transferable?. Eur J Health Econ 6, 334–346 (2005). https://doi.org/10.1007/s10198-005-0322-1

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