Economic evaluations in the EURONHEED: a comparative analysis

A review was performed of the key methodological elements of all the published economic evaluations (EEs), available in the European Network of Health Economics Evaluation Database (EURONHEED), of healthcare technologies conducted in Europe over the past 10 years in order to identify and compare the methodological patterns of EEs conducted in different countries. Selected for analysis were summaries of EEs of interventions for bacterial and viral infections, and diseases of the digestive and respiratory tracts. The summaries were obtained from the EURONHEED. There were 346 studies that fulfilled the selection criteria. The statistical analyses consisted of a descriptive analysis and a bivariate inference analysis to assess associations between the different variables, essentially between the variables of country, year of publication and methodology applied. Of the summaries examined, approximately 50% focused on pharmacological interventions. The most frequent type of analysis was that of cost effectiveness. The technologies most evaluated referred to treatments (versus diagnosis or prevention technologies). The perspective was mostly that of the health service. The sensitivity analysis most applied was univariate and the model type mostly used was the decision-tree. Over the period assessed, there were significant differences between countries in the types of EE, the perspective from which the studies were performed and in the practice of discounting costs and health effects. Although there has been an improvement in methodologies since the year 2000, there are studies that still fail to take into account key elements of EE necessary for a study to be considered of high quality. For better appreciation of the potential capacity for the transfer of results of EEs between jurisdictions, the methodologies used in health EE studies in the different European countries need to be known in greater detail.