OBJECTIVES: Rapid developments in the field of HTA have been made in the last years. To keep up with methodological and policy developments, the Dutch guideline for economic evaluations in healthcare was due for an update.

METHODS: A survey was sent out to parties that are known to use the guideline in practice, consisting of academia, the pharmaceutical industry and consultancy firms. The aim of the survey was to assess which topics should be addressed in this update. Furthermore, an expert committee was established that acted as an advisory board to the National Health Care institute during the update of the guideline. The expert committee assisted in developing a prioritized list of topics to be addressed. During four expert meetings, consensus was sought regarding including, excluding and/or changing recommendations on how to perform economic evaluations in the Dutch healthcare setting.

RESULTS: In total 30 respondents filled in the survey. Half of the respondents was from academia (n=15, 50%). Topics that were mentioned most frequently were more guidance on dealing with missing data, trial-based economic evaluations and expert validation. Additionally, more recommendations on dealing with subgroups and quality of life of informal caregivers were mentioned. One by one, these topics were handled in the experts meetings which resulted in either including, excluding and/or changing recommendations.

CONCLUSIONS: Important updates have been made to the Dutch guideline which are aimed to improve the quality of economic evaluations performed in the Netherlands. Several topics for further research have been identified during this update, which include the value of health to underpin what discounting rates to use, estimation of quality of life of informal caregivers, how to include sustainability in economic evaluations and the development of generic quality of life questionnaires for long-term care.