Integrating Metrics of Environmental Sustainability into Economic Evaluations: A Targeted Literature Review
Author(s)
Zipporah R. Abraham Paiss, BA, Ellie Goldman, MPH, Sumudu Dehipawala, MPH, Liz Hamilton, MPH, Abigail Silber, MPH, Matthew O'Hara, MBA.
Trinity Life Sciences, Waltham, MA, USA.
Trinity Life Sciences, Waltham, MA, USA.
Presentation Documents
OBJECTIVES: This study examines how environmental sustainability (ES) metrics have been incorporated into economic evaluations and proposes new innovative methodologies for advancing the integration of ES into these frameworks.
METHODS: A targeted literature review was conducted to identify existing approaches to incorporating ES metrics into economic evaluations. Peer-reviewed articles, conference materials, and HTAs were analyzed to synthesize key methodologies and identify gaps in current approaches, focusing on practical implementation and alignment with decision-making priorities.
RESULTS: Eighteen relevant papers were identified from January 2017 to December 2024. Existing approaches that HTAs have taken to integrate ES metrics into economic evaluations include hybrid cost models that adjust willingness-to-pay thresholds to account for environmental externalities (e.g., carbon emissions), incremental carbon footprint ratios that quantify trade-offs between environmental and economic outcomes, and life cycle analyses that leverage scenario-based modeling to evaluate long-term environmental impacts (e.g., waste reduction), among other approaches.
CONCLUSIONS: HTAs have sought to incorporate ES into evaluation metrics, highlighting the growing influence this component may have in future assessments. This research highlights that methods for ES analysis are still crystallizing. Creating more codified analytical approaches and tools could enhance the incorporation of sustainability in HTA evaluation frameworks, making them more accessible to non-experts, and aiding discussions with various stakeholders, including policymakers and patients. While these methods highlight the applicability of established HEOR modeling techniques in ES, additional novel methodologies could be considered as the focus on environmental sustainability becomes more prevalent in healthcare. Based on these findings, the authors of this research propose the use of “gamified environmental metrics” to address critical gaps by using interactive dashboards that visually simulate trade-offs between clinical, economic, and environmental outcomes in a visual, intuitive way. Future research should focus on operationalizing these methods to optimize clinical, economic, humanistic, and environmental priorities.
METHODS: A targeted literature review was conducted to identify existing approaches to incorporating ES metrics into economic evaluations. Peer-reviewed articles, conference materials, and HTAs were analyzed to synthesize key methodologies and identify gaps in current approaches, focusing on practical implementation and alignment with decision-making priorities.
RESULTS: Eighteen relevant papers were identified from January 2017 to December 2024. Existing approaches that HTAs have taken to integrate ES metrics into economic evaluations include hybrid cost models that adjust willingness-to-pay thresholds to account for environmental externalities (e.g., carbon emissions), incremental carbon footprint ratios that quantify trade-offs between environmental and economic outcomes, and life cycle analyses that leverage scenario-based modeling to evaluate long-term environmental impacts (e.g., waste reduction), among other approaches.
CONCLUSIONS: HTAs have sought to incorporate ES into evaluation metrics, highlighting the growing influence this component may have in future assessments. This research highlights that methods for ES analysis are still crystallizing. Creating more codified analytical approaches and tools could enhance the incorporation of sustainability in HTA evaluation frameworks, making them more accessible to non-experts, and aiding discussions with various stakeholders, including policymakers and patients. While these methods highlight the applicability of established HEOR modeling techniques in ES, additional novel methodologies could be considered as the focus on environmental sustainability becomes more prevalent in healthcare. Based on these findings, the authors of this research propose the use of “gamified environmental metrics” to address critical gaps by using interactive dashboards that visually simulate trade-offs between clinical, economic, and environmental outcomes in a visual, intuitive way. Future research should focus on operationalizing these methods to optimize clinical, economic, humanistic, and environmental priorities.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE422
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas