Plain Language Summary

The Dutch guideline for economic evaluations in healthcare has been updated to better assess the value of health technologies using a broad societal perspective. This revision is crucial because economic evaluations help determine which health technologies can be funded and used in healthcare systems, helping to ensure that limited healthcare resources are used effectively. This update is particularly relevant for patients, healthcare providers, and policy makers, as it incorporates modern methods and addresses new research areas, ensuring that evaluations are transparent, comprehensive, consistent, and high-quality.

The revision process involved extensive consultation with stakeholders, including pharmaceutical companies, academic research groups, and government organizations. Feedback was gathered through surveys, and a committee of experts from various fields of health economics guided the revisions during several meetings. The final version was launched in January 2024.

Key updates include a reduction in the discount rate for costs from 4% to 3%, which better reflects economic conditions and aligns with other Dutch cost-benefit guidelines, while maintaining the discount rate for effects at 1.5%. This makes future healthcare costs weigh slightly more in current decisions.

Importantly, the guideline now recommends considering the health-related quality of life of informal caregivers in scenario analyses. This means that the emotional and physical impact on those who support patients, such as family members, should be acknowledged in evaluations. Additionally, the inclusion of indirect medical costs that occur during extended life-years is now required in the main analysis, not just in optional scenarios. This ensures a more accurate reflection of total costs associated with longer life expectancy due to treatment.

Probabilistic analyses, which better account for uncertainty in model inputs, are now mandatory for base case results. This shift improves the reliability of findings and assessors’ understanding of decision uncertainty. Another significant addition is the requirement to perform value of information analyses. These help identify where more research could reduce uncertainty in decision making, making it easier to judge whether further data collection is worthwhile. Furthermore, trial-based evaluations also receive more detailed guidance to help researchers use the best methods available and improve the quality of their work.

The updated costing manual, a critical resource for estimating healthcare and societal costs, includes refreshed reference prices and new categories for diagnostics, medical devices, and mental healthcare have been added. These updates ensure that economic evaluations use current cost data, improving their accuracy and relevance. The revised guideline also strengthens requirements for including expert opinions by mandating clearer documentation and differentiation between qualitative opinions and quantitative estimates.

Finally, the advisory committee has identified areas needing further research, such as updating willingness-to-pay thresholds and developing a generic measure for well-being. These areas are essential for ensuring that economic evaluations remain relevant and comprehensive as healthcare and societal contexts evolve.

Overall, the updated Dutch guideline ensures that economic evaluations remain highly relevant, scientifically robust, and aligned with societal values. It supports healthcare decisions that consider not only the patient but also caregivers and broader societal impacts.

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