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)
http://www.cadth.ca/
http://www.cadth.ca/
Additional Information:
Guidelines not updated since 2017.
Information current as of Tuesday, January 9, 2024
Key Features
| 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 | Audience that is technically literate about the methods of economic evaluation. Canadian healthcare decision makers who are responsible for the funding decisions regarding health technologies. Researchers 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. Must be based on the condition, likely impact of the intervention and decision problem. |
| 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. Concept and development should be based on the decsion problem. Be consistent with the health condiction, intervention and comparators. Should be referenced from existing validated models. Should not be more complex than is necassry to address the problem. Should be subjected to rigorous internal validation. |
| 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 | Recommended rate for reference case, 1.5% per year for both cost and outcomes. To account for uncertainty and assess sensitivity to changes, 0-3% per year. |
| 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 |
Acknowledgement: