CHALLENGES FACED IN TRANSFERRING ECONOMIC EVALUATIONS TO MIDDLE INCOME COUNTRIES

DRUMMOND M,; AUGUSTOVSKI F,; KALÓ Z, ; YANG BM,; PICHON RIVIERE, A.; BAE EY,; KAMAL-BAHL S

INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE

CAMBRIDGE UNIV PRESS

Lugar: Cambridge; Año: 2015

0266-4623

BACKGROUND: Decision makers in middle income countries are using economic evaluations (EEs) inpricing and reimbursement decisions for pharmaceuticals. However, whilst many of these jurisdictionshave local submission guidelines and local expertise, the studies themselves often use economic modelsdeveloped elsewhere and elements of data from countries other than the jurisdiction concerned. Theobjectives of this study were to describe the current situation and to assess the challenges faced bydecision makers in transferring data and analyses from other jurisdictions.METHODS: Experienced health service researchers in each region conducted an interview survey ofrepresentatives of decision making bodies from jurisdictions in Asia, Central and Eastern Europe, andL;デｷﾐ AﾏWヴｷI; デｴ;デ ｴ;S ;デ ﾉW;ゲデ ﾗﾐW ┞W;ヴげゲ W┝ヮWヴｷWﾐIW ﾗa ┌ゲｷﾐｪ EEゲくRESULTS: Representatives of the relevant organizations in 12 countries were interviewed. All 12jurisdictions had developed official guidelines for the conduct of EEs. All but one of the organizationsevaluated studies submitted to them, but 9 also conducted studies and 7 commissioned them. Nine ofthe organizations stated that, in evaluating EEs submitted to them, they had consulted a studyperformed in a different jurisdiction. Data on relevant treatment effect was generally considered moretransferable than those on prices/unit costs. Views on the transferability of epidemiological data, dataon resource use and health state preference values were more mixed. Eight of the respondents statedthat analyses submitted to them had used models developed in other jurisdictions. Four of theorganizations had a policy requiring models to be adapted to reflect local circumstances. The mainobstacles to transferring EEs were the different patterns of care or wealth of the developed countriesfrom which most economic evaluations originate.CONCLUSIONS: In middle income countries it is commonplace to deal with the issue of transferringanalyses or data from other jurisdictions. Decision makers in these countries face several challenges,mainly due to differences in current standard of care, practice patterns or GDP between the developedcountries where the majority of the studies are conducted and their own jurisdiction