Economic and Resource Use-Related Guidance in US Medical Societies' Clinical Practice Guidelines

Area of Science:

• Health Economics
• Clinical Practice Guidelines
• Value-Based Care

Background:

• Clinical practice guidelines (CPGs) are crucial for evidence-based healthcare.
• The integration of economic considerations into CPGs is vital for informing value-based care.
• The extent to which current CPGs incorporate economic or resource use guidance is not well understood.

Purpose of the Study:

• To determine the proportion of CPG recommendations that include economic or resource use considerations.
• To identify factors associated with the inclusion of economic or resource use considerations in CPGs.

Main Methods:

• A cross-sectional study analyzed 309 CPG documents from 23 US medical societies published between 2019 and 2023.
• Data extraction focused on recommendation-level, guideline-level, and society-level characteristics.
• Multivariable analyses assessed factors associated with the presence of economic or resource use guidance.

Main Results:

• Of 7582 recommendations, only 3.8% included upfront economic statements and 22.5% discussed economic evidence.
• Recommendations from primary care societies were more likely to have upfront economic statements (OR, 12.81).
• Societies explicitly suggesting economic evidence consideration had more narrative discussions (OR, 6.26), but multisociety guidelines were less likely to include economic considerations.

Conclusions:

• While most societies suggest considering economic evidence, its incorporation into CPG recommendations remains infrequent.
• Enhancing the quality of health economic evidence and its explicit consideration by societies can improve CPGs' utility for value-based care.
• Further research into barriers and facilitators for integrating economic evidence into CPGs is warranted.