OBJECTIVES: The care pathway is the journey that a patient with a specific medical condition takes during an episode of healthcare. Care pathway analysis (CPA) is a methodology that facilitates the identification and mapping (using a flow diagram) of medical decisions within the current pathway for a certain condition. The objective of this work is to raise awareness about CPA and situations where this methodology is useful in health economics and outcomes research.

METHODS: Initially, CPA involves a pragmatic review to identify and synthesise national and international guidelines that describe the care pathway for the condition of interest. This is followed by a qualitative evaluation using semi-structured interviews and thematic analysis. Interviews with experts (clinicians and/or other relevant stakeholders) are undertaken to understand where (and why) real-world practices differ from the published guidance. These are used to validate the care pathway and to capture variations in clinical practice among clinicians/countries.

RESULTS: CPA can be used to optimise the structure of economic models and inform evidence generation requirements. Practical applications from two CPA projects will be presented: the first focussed on a new treatment for cataracts and the second on adult-onset Still’s disease. For diagnostics and devices, CPA is useful in the early stages of product development. In this situation, CPA can help identify the added value of the new technology and its optimal positioning within the care pathway, alongside potential barriers/facilitators for adoption. In drug evaluations, CPA is more useful in situations where there is a lack of robust data. For example, in rare diseases where clinical guidelines are often limited, and care pathways can be characterised by high variability.

CONCLUSIONS: CPA can support the development of economic models and is particularly useful in certain situations; for example, for new diagnostics and devices and in drug evaluations for rare diseases.