Headroom Analysis for Early Economic Evaluation: A Systematic Review.

Area of Science:

• Health Economics
• Pharmacoeconomics
• Health Technology Assessment

Background:

• Headroom analysis is an early economic evaluation method to determine the maximum price for cost-effectiveness.
• A comprehensive review of its application in healthcare is lacking.
• This study systematically reviews how headroom analysis is framed, applied, and reported.

Approach:

• A systematic literature search was performed across major databases (PubMed, Embase, Web of Science, EconLit, Google Scholar).
• Studies applying headroom analysis were included and data were descriptively summarized.
• The review focused on the framing, analytical methods, evidence sources, and use of expert judgment.

Key Points:

• Headroom analysis was applied to medicines, diagnostics, procedures, and medical devices.
• Model-based analyses were predominantly used, with varying model complexity and effectiveness assumptions.
• Expert judgment was utilized in 71% of studies, through opinion or elicitation.

Conclusions:

• The application of headroom analysis in healthcare exhibits considerable variability.
• Clear reporting of analytical approaches, evidence base, and expert judgment is recommended.
• Standardization would enhance the appropriate use and interpretation of headroom analysis.