Country/Region: Croatia
Published PE Recommendations

Guide for the Economic Evaluation of Health Technologies: Croatia; as part of the Croatian Guideline for Health Technology Assessment Process and Reporting, 1st ed Zagreb, February 2011
http://aaz.hr/hr/procjena-zdravstvenih-tehnologija/smjernice

PDF in English
http://aaz.hr/sites/default/files/hrvatske_smjernice_za_procjenu_zdravstvenih_tehnologija.pdf

Published PE Recommendations Source:

Agency for Quality and Accreditation in Health Care and Social Welfare, Department for Development, Research and Health Technology Assessment. The Croatian Guideline for Health Technology Assessment Process and Reporting, 1st ed Zagreb, February 2011.

Additional Information:

Agency for Quality and Accreditation in Health Care and Social Welfare
http://www.aaz.hr

Last Webpage Update: Monday, February 22, 2016

Published PE Recommendations Key Features:

Key Features:  
Title and year of the document
The Croatian Guideline for Health Technology Assessment Process and Reporting, 1st ed Zagreb, February 2011. Part 6 Guide for the Economic Evaluation of Health Technologies: Croatia 
Affiliation of authors
Agency for Quality and Accreditation in Health Care, Department for Development, Research and Health Technology Assessment and Academia  
Purpose of the document
To produce credible and standardized information that is relevant and useful to decision makers in Croatian publicly funded health care system, and to meet their needs for reliable, consistent, timely and relevant HTA information.
Croatian HTA reports should serve as recommendations, with aims to support policymakers at national level, particularly Croatian Ministry of Health and Social Welfare and Croatian Institute for Health Insurance, in making evidence-informed decisions on the strategic planning, investment, management and the implementation of technologies in health care, on funding (reimbursement) and coverage of health technologies, and, on hospital level, on requests from hospital directors and policy teams.  
Standard reporting format included
Yes  
Disclosure
Yes  
Target audience of funding/ author's interests
Policymakers at national level, particularly Croatian Ministry of Health and Social Welfare and Croatian Institute for Health Insurance, and, on hospital level, hospital directors and policy teams. 
Perspective
Croatian Institute for Health Insurance (as public payer) (societal perspective, including all cost and benefits outside the health care system, may be presented in addition, if considered relevant for some topics) 
Indication
Licensed one(s)  
Target population
Yes 
Subgroup analysis
Yes 
Choice of comparator
Therapies routinely used in the Croatian health system, including technologies regarded as current best practice. 
Time horizon
Sufficiently long to reflect all important differences in costs or outcomes between the technologies being compared 
Assumptions required
Yes 
Preferred analytical technique
Cost-effectiveness analysis (CEA) or Cost-utility analysis, (CUA), depending on the particularities of the technology being assessed 
Costs to be included
Yes 
Source of costs
Direct cost relevant to Croatian Institute for Health Insurance (where measurable and relevant, indirect costs and cost falling outside of Croatian Institute for Health Insurance should be reported separately) 
Modeling
Yes  
Systematic review of evidences
Yes  
Preference for effectiveness over efficacy
Yes, modeling and/or sensitivity analysis should be used to extrapolate efficacy data 
Preferred outcome measure
Measure of health effects: Natural units (CEA) or QALYs (CUA) Measurement of QALY gains: Reported directly by patients and/or informal caregivers 
Preferred method to derive utility
EQ-5D 
Equity issues stated
Yes 
Discounting costs
An annual rate of 5% on both costs and health effects (in sensitivity analyses between 3% and 10%) 
Discounting outcomes
An annual rate of 5% on both costs and health effects (in sensitivity analyses between 3% and 10%) 
Sensitivity analysis-parameters and range
On uncertain parameters 
Sensitivity analysis-methods
Probabilistic sensitivity analysis 
Presenting results
For clarity, reproducibility, and future use of data, results of total costs and total gains should be clearly stated 
Incremental analysis
Yes 
Total costs vs effectiveness (cost/effectiveness ratio)
Yes 
Portability of results (Generalizability)
Yes 
Financial impact analysis
Budget Impact Analysis (BIA) is mandatory for submission to the Croatian Health Insurance Fund, and this should be done according the ISPOR BIA guidelines 
Mandatory or recommended or voluntary
Recommended 

Acknowledgement: Mirjana Huić, MD, PhD, Department for Development, Research and Health Technology Assessment; Agency for Quality and Accreditation in Health Care and Social Welfare contributed to the key feature form

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