“…33,34 There can be significant heterogeneity in study design (eg, trial analyses versus modeling), costing methods, discounting, measures of effectiveness, mechanisms for quality adjustment, and time horizons. 21,[33][34][35][36][37][38] It is recommended that the quality of each economic study considered be assessed using a standard, validated tool. The Quality of Health Economic Studies (QHES) instrument (Table 1) 33 is one available tool to assess the quality of economic studies.…”