OBJECTIVES: This study aims to analyze the role of health economic evidence in clinical practice guidelines (CPGs) published in China from 2017 to 2022.

METHODS: A literature search was conducted using China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database (CBM), the VIP database, the Wanfang database, and the Chinese Medical Association database (CMA) from 2017 to 2022. The literature was screened, and data were extracted by two researchers independently. The involvement of health economists and the health economic evidence cited in CPGs were summarized. We evaluated the types of health economic evidence cited in CPGs and used the latest published CHEQUE tool to evaluate the methodological and reporting quality.

RESULTS: A total of 793 clinical practice guidelines were included in the analysis, out of which only 8 (1.0%) explicitly stated the involvement of health economists,179 (22.5%) included references to health economics in their text, with eight of them doing so only in the context of limitations mentioned within the guideline. Among the 179 guidelines, 44 guidelines (5.5%) cited health economic evidence, with 63 studies referenced. Of these, 42 studies were conducted outside China, while the remaining 21 were conducted domestically. Out of 21 studies conducted in the context of China's environment, full-text downloads are available for 18 studies, including four reviews and 14 original studies. Among the 14 original studies, 11 are cost-effectiveness analysis (CEA) studies and three are disease burden studies. There was a significant variation in the scores among the different CHEQUE items. The methodological quality score for the 14 CEAs was 82.79±22.10, and the reporting quality score was 80.39±18.94.

CONCLUSIONS: Only a limited proportion of Chinese CPGs have adopted health economic evidence. Standardized rules in the quality assessment and use of health economic evidence in the development of CPGs have yet to be established.