Country/Region: South Africa
Published PE Recommendations

Guidelines for Pharmacoeconomic Evaluations of Medicines and Scheduled Substances (February 2013)
PDF in English

Published PE Recommendations Source:
Additional Information:
Last Webpage Update: Wednesday, January 17, 2018

Published PE Recommendations Key Features:

Key Features:  
Title and year of the document
Guidelines for Pharmacoeconomic Submissions (December 2012)  
Affiliation of authors
National Department of Health 
Purpose of the document
To describe the process to be followed for PE applications and the criteria for medicines which require submissions; To create a forum which provides independent and objective review of the value of medicines 
Standard reporting format included
Yes 
Disclosure
Nothing required 
Target audience of funding/ author's interests
Pharmaceutical companies, researchers, decision makers 
Perspective
Default perspective: third-party payer. Option to use a broader perspective where justified according to specific considerations. 
Indication
Approved Indication 
Target population
If submission pertains to a specific sub-group, within the registered indication, this must be clearly defined 
Subgroup analysis
Yes (only if the group has been defined a priori in the clinical trial protocol and the study was sufficiently powered to analyse specified strata. 
Choice of comparator
The main comparator is deemed to be the standard of care for local practice. All possible comparators need to be listed and justified. 
Time horizon
Time Horizon is based on the natural course of the condition and the likely impact of the treatment. Depending on the type of intervention, it may be necessary to present a short term analysis based on the primary clinical data. 
Assumptions required
Yes 
Preferred analytical technique
Any of CMA, CEA, CUA and CBA considered but choice of analysis must be clearly justified. The modelled evaluation should be based on the outcomes measures which most closely validly estimate the final outcome. 
Costs to be included
Direct costs. Indirect costs should generally be excluded. 
Source of costs
No prefered source specified, although table needs to be provided clearly identifying the source of the reference for unit costs. 
Modeling
Yes - where randomised trials available do not provide sufficient information. Modelling options include spreadsheet analysis, decision analysis, Markov models and Monte Carlo simulations. 
Systematic review of evidences
Yes, including crtieria for inclusion and exclusion of sources of evidence, evaluation of clinical trials for inclusion, assessment of measures taken to minimize bias, meta-analysis and indirect comparison. Searhc strategy to be clearly defined and be reproducible. 
Preference for effectiveness over efficacy
Yes 
Preferred outcome measure
Life Years Gained, deaths prevented or QALYs gained 
Preferred method to derive utility
No preference stated for measurement of utilities 
Equity issues stated
No differentiation between QALYs accruing to different groups 
Discounting costs
Future costs should be discounted at an annual rate of 5% (range 0% to 10% for sensitivity analysis) 
Discounting outcomes
Future benefits should be discounted at an annual rate of 5% (range 0% to 10% for sensitivity analysis) 
Sensitivity analysis-parameters and range
Sensitivity analysis must be conducted on all variables using an appropriate range, as justified and referenced. Results to be presented in tabular form and tornado diagrams. 
Sensitivity analysis-methods
One way sensitivity analysis must be conducted on all variables using an appropriate range, as justified and referenced. Two-way sensitivity analysis should be conducted on variables shown to be sensitive in the one-way analysis. 
Presenting results
Results to be presented in a disaggregated form, and then increasingly aggregated. Present appropriately aggregated and discounted costs results separately for outcomes and resources and separtely for proposed medicine and its comparator. The final outcome should be presented as an ICER. 
Incremental analysis
Yes 
Total costs vs effectiveness (cost/effectiveness ratio)
Yes 
Portability of results (Generalizability)
The patient population to which the pharmaco-economic evaluation applies should be consistent with the patient population defined in the clinical part of the reimbursement request submission. 
Financial impact analysis
Not specified 
Mandatory or recommended or voluntary
Currently, the submission for pharmacoeconomic assessment is essentially voluntary, however, key figures in the Department of Health have to power to "call a product up" for economic assessment. 

Acknowledgement: ISPOR South Africa Chapter highly contributed to the Published PE Recommendations in South Africa and the key feature form.

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