“…With the exception of the manuals from three HTA agencies [7,20,27], the purpose of the manuals is to specify methods for reports used to support reimbursement decisions [12,17,19,21-23,25,26,29,30],[35]. …”
Section: Resultsmentioning
confidence: 99%
“…Five HTA agencies evaluated exclusively drugs [21,22,29,30,35]. CVZ states that its guidelines are intended for designing and conducting pharmacoeconomic research, but that they are also applicable to economic evaluations in general [22].…”
Section: Resultsmentioning
confidence: 99%
“…Usual care is required by the primary comparator of 11 agencies [17,19,20,22,23,25-27,30,35]. The least expensive treatment alternative, recommended/guideline care or all relevant alternatives are often recommended for further analysis.…”
BackgroundThe number of Health Technology Assessment (HTA) agencies increases. One component of HTAs are economic aspects. To incorporate economic aspects commonly economic evaluations are performed. A convergence of recommendations for methods of health economic evaluations between international HTA agencies would facilitate the adaption of results to different settings and avoid unnecessary expense. A first step in this direction is a detailed analysis of existing similarities and differences in recommendations to identify potential for harmonization. The objective is to provide an overview and comparison of the methodological recommendations of international HTA agencies for economic evaluations.MethodsThe webpages of 127 international HTA agencies were searched for guidelines containing recommendations on methods for the preparation of economic evaluations. Additionally, the HTA agencies were requested information on methods for economic evaluations. Recommendations of the included guidelines were extracted in standardized tables according to 13 methodological aspects. All process steps were performed independently by two reviewers.ResultsFinally 25 publications of 14 HTA agencies were included in the analysis. Methods for economic evaluations vary widely. The greatest accordance could be found for the type of analysis and comparator. Cost-utility-analyses or cost-effectiveness-analyses are recommended. The comparator should continuously be usual care. Again the greatest differences were shown in the recommendations on the measurement/sources of effects, discounting and in the analysis of sensitivity. The main difference regarding effects is the focus either on efficacy or effectiveness. Recommended discounting rates range from 1.5% - 5% for effects and 3% - 5% for costs whereby it is mostly recommended to use the same rate for costs and effects. With respect to the analysis of sensitivity the main difference is that oftentimes the probabilistic or deterministic approach is recommended exclusively. Methods for modeling are only described vaguely and mainly with the rational that the “appropriate model” depends on the decision problem. Considering all other aspects a comparison is challenging as recommendations vary regarding detailedness and addressed issues.ConclusionThere is a considerable unexplainable variance in recommendations. Further effort is needed to harmonize methods for preparing economic evaluations.
“…With the exception of the manuals from three HTA agencies [7,20,27], the purpose of the manuals is to specify methods for reports used to support reimbursement decisions [12,17,19,21-23,25,26,29,30],[35]. …”
Section: Resultsmentioning
confidence: 99%
“…Five HTA agencies evaluated exclusively drugs [21,22,29,30,35]. CVZ states that its guidelines are intended for designing and conducting pharmacoeconomic research, but that they are also applicable to economic evaluations in general [22].…”
Section: Resultsmentioning
confidence: 99%
“…Usual care is required by the primary comparator of 11 agencies [17,19,20,22,23,25-27,30,35]. The least expensive treatment alternative, recommended/guideline care or all relevant alternatives are often recommended for further analysis.…”
BackgroundThe number of Health Technology Assessment (HTA) agencies increases. One component of HTAs are economic aspects. To incorporate economic aspects commonly economic evaluations are performed. A convergence of recommendations for methods of health economic evaluations between international HTA agencies would facilitate the adaption of results to different settings and avoid unnecessary expense. A first step in this direction is a detailed analysis of existing similarities and differences in recommendations to identify potential for harmonization. The objective is to provide an overview and comparison of the methodological recommendations of international HTA agencies for economic evaluations.MethodsThe webpages of 127 international HTA agencies were searched for guidelines containing recommendations on methods for the preparation of economic evaluations. Additionally, the HTA agencies were requested information on methods for economic evaluations. Recommendations of the included guidelines were extracted in standardized tables according to 13 methodological aspects. All process steps were performed independently by two reviewers.ResultsFinally 25 publications of 14 HTA agencies were included in the analysis. Methods for economic evaluations vary widely. The greatest accordance could be found for the type of analysis and comparator. Cost-utility-analyses or cost-effectiveness-analyses are recommended. The comparator should continuously be usual care. Again the greatest differences were shown in the recommendations on the measurement/sources of effects, discounting and in the analysis of sensitivity. The main difference regarding effects is the focus either on efficacy or effectiveness. Recommended discounting rates range from 1.5% - 5% for effects and 3% - 5% for costs whereby it is mostly recommended to use the same rate for costs and effects. With respect to the analysis of sensitivity the main difference is that oftentimes the probabilistic or deterministic approach is recommended exclusively. Methods for modeling are only described vaguely and mainly with the rational that the “appropriate model” depends on the decision problem. Considering all other aspects a comparison is challenging as recommendations vary regarding detailedness and addressed issues.ConclusionThere is a considerable unexplainable variance in recommendations. Further effort is needed to harmonize methods for preparing economic evaluations.
“…However, only few published studies offer maps of radionuclide distribution (Dragovi c et al 2014;Erenturk et al 2014), in particular for uranium mining impacted environments (Vandenhove et al 2006;Bollh€ ofer et al 2006Bollh€ ofer et al , 2014. Moreover, the considered areas usually vary from 10 to 100 km 2 and do not allow us to determine local accumulation areas.…”
“…Radon-222 exhalation flux from the rehabilitated footprint will ultimately depend on the 226 Ra activity concentration of the cover and the parameters derived here and previous research (Bollh€ ofer et al, 2014) allow to calculate an above background component of the 222 Rn exhalation flux. The range of the measured R E-R is large, but will allow worst case scenarios to be developed for the above background component of the 222 Rn flux from the rehabilitated site.…”
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