OBJECTIVES: Systematic literature reviews (SLRs) often use quality assessment (QA) tools to aid interpretation of the overall reliability of the study findings. Various QA tools are available specifically for assessing the quality of health economic evaluations (EEs), however, it is crucial to differentiate between evaluating methodological quality (how well an EE was designed and conducted) and reporting quality (the description of the methods and findings). The objective of this study was to analyse the utilisation of QA tools in recent SLRs focusing on EEs.

METHODS: A search was conducted in Embase and Medline to identify SLRs of EEs of health interventions published between 2022 and June 2024. Inclusion criteria were limited to EEs in oncology, cardiovascular disease (CVD), infectious diseases, diabetes, substance use disorder (SUD), and mental disorders. Studies only presented as conference abstracts, methodological studies, or those involving solely children and adolescents were excluded. For each included SLR, we noted which QA tools and checklists were used to assess methodological quality.

RESULTS: The literature searches identified 677 results, of which 145 met our inclusion criteria (oncology 40; CVD 36; infectious diseases 31; mental disorders 22; diabetes 12; SUD 4). The most frequently reported QA tools were the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) (39.3%), Drummond’s checklist (13.1%), and Consensus Health Economic Criteria (10.4%). Twelve studies (8.3%) did not mention using any QA tool, while 4.8% used CHEERS for reporting quality evaluation alongside another tool for methodological quality assessment.

CONCLUSIONS: Despite caution from CHEERS authors about its unsuitability for assessing methodological quality and the potential misinterpretation of study findings, CHEERS remains the most widely employed QA tool in SLRs of EEs. Authors conducting SLRs of EEs should be guided towards utilising appropriate tools designed specifically for assessing methodological quality rather than relying solely on reporting standards like CHEERS.