Country/Region: Canada
PE Guidelines

Guidelines for the Economic Evaluation of Health Technologies: Canada (4th ed, 2017)
PDF in English

PE Guidelines Source:

Canadian Agency for Drugs and Technologies in Health (CADTH)

Additional Information:
Information up to date as of Wednesday, January 31, 2018

PE Guidelines Key Features:

Key Features:  
Title and year of the document
Guidelines for the Economic Evaluation of Health Technologies: Canada (4th ed, 2017) 
Affiliation of authors
Canadian Agency for Drugs and Technologies in Health (CADTH) 
Purpose of the document
Inform decision-making regarding the cost effectiveness of health technologies including drugs. Provide best practices for conducting economic evaluations of health care interventions in Canada. Useful for providing standardized and reliable information to the target audience. Providing a template for final reports. 
Standard reporting format included
Target audience of funding/ author's interests
Canadian decision and policy makers who are responsible for the funding decisions regarding health technologies. Researches conducting economic evaluations to inform decision making and policy 
The perspective in the references case should be that of the publicly funded health care payer, but may deviate depending on the decision problem. 
Of interest to the decision maker  
Target population
Be clearly specified, reflecting¬†expected use of the intervention(s) and consistent with the decision problem.  
Subgroup analysis
Choice of comparator
Current care (i.e., the intervention[s] presently used in a Canadian context), related to the scope of the decision problem. This may include more than one relevant comparator. 
Time horizon
The time horizon should be long enough to capture all the meaningful differences in costs and outcomes between the intervention and comparators. 
Assumptions required
Preferred analytical technique
Costs to be included
All direct health care costs, based on the perspective of the publicly funded health care payer. When a range of perspectives is relevant to the decision problem, results should be reported separately for the reference case perspective and any additional non-reference case perspectives.  
Source of costs
Guidance Document for the Costing of Health Care Resources in the Canadian Setting (2nd Edition, 2016)  
Yes. Choice of modelling technique should be justified. The approach should be no more complex than necessary to address the decision problem.  
Systematic review of evidences
Preference for effectiveness over efficacy
Preferred outcome measure
Preferred method to derive utility
Indirect methods based on generic classification system, based on a general Canadian population  
Equity issues stated
All outcomes should be weighted equally, regardless of the characteristics of people receiving, or affected by, the intervention. Equity concerns should be approached by acknowledging the potential implications of both horizontal equity (equal treatment of equals) and vertical equity (unequal treatment of unequals).  
Discounting costs
Yes, standard 1.5%; conduct sensitivity analyses using 0%, 3%  
Discounting outcomes
Yes, standard 1.5%; conduct sensitivity analyses using 0%, 3%  
Sensitivity analysis-parameters and range
Reference case should be conducted probabilistically to account for parameter uncertainty  
Sensitivity analysis-methods
Scenario analyses to examine structural uncertainty, which should be conducted probabilistically  
Presenting results
Reports both in disaggregated and aggregated form. Where there are more than two comparators, a sequential analysis of cost effectiveness should be conducted following standard rules for estimating ICERs, including the exclusion of dominated interventions.¬†  
Incremental analysis
Total costs vs effectiveness (cost/effectiveness ratio)
Portability of results (Generalizability)
Addressed within the assessment for each of the components of the economic evaluation  
Financial impact analysis
Budgeting exercise for affected organizations, not a part of economic evaluation¬†  
Mandatory or recommended or voluntary

Acknowledgement: Karen Lee, MA, Director, Health Economics, Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, ON, Canada contributed to the key feature form

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