Pharmacoeconomic Guidelines: Canada

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)

Information current as of Monday, July 18, 2022

Key Features

Type of Guidelines PE Guidelines
Title and year of the document Guidelines for the Economic Evaluation of Health Technologies: Canada (4th ed, 2017)
Affiliation of authors Canadian Agency for Drugs and Technologies in Health (CADTH)
Purpose of the document Inform 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 included Yes
Disclosure Yes
Target audience of funding/ author's interests Canadian decision and policy makers who are responsible for the funding decisions regarding health technologies. Researches conducting economic evaluations to inform decision making and policy
Perspective The perspective in the references case should be that of the publicly funded health care payer, but may deviate depending on the decision problem.
Indication Of interest to the decision maker
Target population Be clearly specified, reflecting expected use of the intervention(s) and consistent with the decision problem.
Subgroup analysis Yes
Choice of comparator Current 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 horizon The time horizon should be long enough to capture all the meaningful differences in costs and outcomes between the intervention and comparators.
Assumptions required Yes
Preferred analytical technique CUA
Costs to be included All 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 costs Guidance Document for the Costing of Health Care Resources in the Canadian Setting (2nd Edition, 2016)
Modeling Yes. Choice of modelling technique should be justified. The approach should be no more complex than necessary to address the decision problem.
Systematic review of evidences Yes
Preference for effectiveness over efficacy Yes
Preferred outcome measure QALYs
Preferred method to derive utility Indirect methods based on generic classification system, based on a general Canadian population
Equity issues stated All 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 costs Yes, standard 1.5%; conduct sensitivity analyses using 0%, 3%
Discounting outcomes Yes, standard 1.5%; conduct sensitivity analyses using 0%, 3%
Sensitivity analysis-parameters and range Reference case should be conducted probabilistically to account for parameter uncertainty
Sensitivity analysis-methods Scenario analyses to examine structural uncertainty, which should be conducted probabilistically
Presenting results Reports 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 analysis Yes
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 analysis Budgeting exercise for affected organizations, not a part of economic evaluation
Mandatory or recommended or voluntary Recommended


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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