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Country/Region: Canada

PE Guidelines
Guidelines for the Economic Evaluation of Health Technologies: Canada (4th ed, 2017)
PDF in English

PE Guidelines Source:
Canadian Agency for Drugs and Technologies in Health (CADTH)

Additional Information:

Last Webpage Update: Wednesday, January 31, 2018

PE Guidelines Key Features:

Key Features:  
Title and year of the documentGuidelines for the Economic Evaluation of Health Technologies: Canada (4th ed, 2017) 
Affiliation of authorsCanadian Agency for Drugs and Technologies in Health (CADTH) 
Purpose of the documentInform decision-making regarding the cost effectiveness of health technologies including drugs. Provide best practices for conducting economic evaluations of health care interventions in Canada. Useful for providing standardized and reliable information to the target audience. Providing a template for final reports. 
Standard reporting format includedYes 
Target audience of funding/ author's interestsCanadian decision and policy makers who are responsible for the funding decisions regarding health technologies. Researches conducting economic evaluations to inform decision making and policy 
PerspectiveThe perspective in the references case should be that of the publicly funded health care payer, but may deviate depending on the decision problem. 
IndicationOf interest to the decision maker  
Target populationBe clearly specified, reflecting expected use of the intervention(s) and consistent with the decision problem.  
Subgroup analysisYes 
Choice of comparatorCurrent care (i.e., the intervention[s] presently used in a Canadian context), related to the scope of the decision problem. This may include more than one relevant comparator. 
Time horizonThe time horizon should be long enough to capture all the meaningful differences in costs and outcomes between the intervention and comparators. 
Assumptions requiredYes 
Preferred analytical techniqueCUA 
Costs to be includedAll direct health care costs, based on the perspective of the publicly funded health care payer. When a range of perspectives is relevant to the decision problem, results should be reported separately for the reference case perspective and any additional non-reference case perspectives.  
Source of costsGuidance Document for the Costing of Health Care Resources in the Canadian Setting (2nd Edition, 2016)  
ModelingYes. Choice of modelling technique should be justified. The approach should be no more complex than necessary to address the decision problem.  
Systematic review of evidencesYes 
Preference for effectiveness over efficacyYes 
Preferred outcome measureQALYs  
Preferred method to derive utilityIndirect methods based on generic classification system, based on a general Canadian population  
Equity issues statedAll outcomes should be weighted equally, regardless of the characteristics of people receiving, or affected by, the intervention. Equity concerns should be approached by acknowledging the potential implications of both horizontal equity (equal treatment of equals) and vertical equity (unequal treatment of unequals).  
Discounting costsYes, standard 1.5%; conduct sensitivity analyses using 0%, 3%  
Discounting outcomesYes, standard 1.5%; conduct sensitivity analyses using 0%, 3%  
Sensitivity analysis-parameters and rangeReference case should be conducted probabilistically to account for parameter uncertainty  
Sensitivity analysis-methodsScenario analyses to examine structural uncertainty, which should be conducted probabilistically  
Presenting resultsReports both in disaggregated and aggregated form. Where there are more than two comparators, a sequential analysis of cost effectiveness should be conducted following standard rules for estimating ICERs, including the exclusion of dominated interventions.   
Incremental analysisYes 
Total costs vs effectiveness (cost/effectiveness ratio)Yes 
Portability of results (Generalizability)Addressed within the assessment for each of the components of the economic evaluation  
Financial impact analysisBudgeting exercise for affected organizations, not a part of economic evaluation   
Mandatory or recommended or voluntaryRecommended 

Acknowledgement: Karen Lee, MA, Director, Health Economics, Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, ON, Canada contributed to the key feature form

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