OBJECTIVES: Over 100 million women use hormonal contraceptives (HC). Unique challenges related to drug-drug interactions as well as unintended pregnancies resulted in an estimated cost of $5-11 billion annually. There is a growing interest in the rigor of pharmacoeconomic (PE) studies due to the allocation of limited resources. In a systematic review of the HC literature, all published PE studies were retrieved and researchers were challenged to choose a PE assessment tool for grading quality. The objective was to review the hormonal contraceptive-pharmacoeconomic literature to identify the most appropriate tool for appraising PE evaluations.

METHODS: A systematic review of literature concerning PE article scoring tools was performed from 2000-2019 using electronic databases (PubMed, Ovid, EBSCO, Cochrane Library). Key search terms used in different combinations: “hormonal contraceptive,” “pharmacoeconomic,” “scoring,” “quality,” “tool,” “article,” “review,” “outcomes,” “health economics,” “cost effectiveness,” “cost utility,” “cost minimization,” “cost benefit”. The inclusion criterion was English language peer-reviewed PE studies describing scoring tools to evaluate methodological quality.

RESULTS: A total of 23 pharmacoeconomic scoring tools met the inclusion criteria. Findings revealed that although checklists and recommendations exist for evaluating the HC-PE literature, quantitative approaches are lacking. The checklists number of items ranged from 8-40 and focused on assessing risk of bias, study quality, and reporting standards. The checklists were useful in assessing the quality and methodology of PE studies, however, only one tool assigned points to each item. There were two tools that categorized each domain into qualitative grades, while the others did not assign scores.

CONCLUSIONS: Appraising the quality of HC-PE literature has become increasingly important for decision makers and those conducting systematic reviews. There is a lack of validation and variability in the criteria which is not weighted. The performance of an effective assessment requires qualitative as well as quantitative aspects. Future research will include the development of such tool.