Methodological Quality of Economic Modelling Studies
The notable increase in the quantity of economic evaluations in the last 2 decades has not been matched by good methodological standards. This problem is particularly evident in the field of economic evaluations of hepatitis B vaccines. The results of 2 systematic reviews conducted by us in 1993 and 1996 showed three problem areas. A sizeable minority of study reports failed to provide a clear study aim, showing a basic ignorance of the first rule of conducting scientific research. The basic epidemiological assumptions upon which the economic models were based showed variability which persisted even after stratification, raising the question of the accuracy of the epidemiological knowledge base of hepatitis B infection and its progression. Lastly, many of the studies showed weaknesses in basic methods of conducting and reporting economic evaluations.
Examination of these problem areas led us to conclude that no conclusions about the efficiency of hepatitis B vaccines could be drawn from the available evidence. Addressing the problem of poor methodological standards concerns the whole research community. However, as a proportion of economic evaluations are published, one obvious means of exerting pressure to increase and maintain methodological standards is the editorial and peer review process. Editors of specialist and general medical journals should agree on and enforce common explicit guidelines for study conduct and reporting, following the example of the British Medical Journal.
KeywordsAdis International Limited Economic Evaluation British Medical Journal Pharmaceutical Benefit Advisory Committee Sizeable Minority
Unable to display preview. Download preview PDF.
- 1.Elixhauser A, editor. Health care cost-benefit and cost-effectiveness analysis (CBA/CEA). From 1979 to 1990: a bibliography. Med Care 1993; 31 Suppl.: JS1–149Google Scholar
- 5.Drummond MF, Jefferson TO, Buxton M, BMJ Working Party on Guidelines for Authors and Peer-Reviewers of Economic Submissions to the British Medical Journal, et al. Guidelines for authors and peer-reviewers of economic submissions to the British Medical Journal. BMJ 1996; 313: 275–83PubMedCrossRefGoogle Scholar
- 8.Commonwealth Department of Health, Housing and Community Services. Guidelines for the pharmaceutical industry on preparation of submissions to the pharmaceutical benefits advisory committee. Canberra: Australian Government Publishing Service, 1992Google Scholar
- 10.Department of Health and Association of British Pharmaceutical Industry. Guidelines for the economic evaluation of pharmaceuticals [press release]. London: Department of Health, 1994Google Scholar
- 11.Canadian Co—ordinating Office for Health Technology Assessment (CCOHTA). Guidelines for economic evaluation of pharmaceuticals: Canada. Ottawa: CCOHTA, 1994Google Scholar
- 12.Gold MR, Siegel JC, Russell LB, et al. Cost—effectiveness analysis in health and medicine. New York: Oxford University Press, 1996Google Scholar
- 14.Demicheli V, Jefferson TO. An exploratory review of the economics of recombinant vaccines against Hepatitis B (HB). In: Ronchi E, editor. Biotechnology and medical innovation: socio-economic assessment of the technology, the potential and the products. Paris: Organisation for Economic Cooperation and Development (OECD), 1997: 105–23Google Scholar
- 16.World Health Organization (WHO). International list of availability of vaccines and sera. 4th ed. Geneva: WHO, 1996Google Scholar
- 18.Margolis HS, Schats GC, Kane MA. Development of recommendations for control of Hepatitis B virus infections: the role of cost analysis. In: Blumberg BS, Hepburn A, André FE, editors. Proceedings of the international conference on prospects for eradication of Hepatitis B virus. Vaccine 1990; 8: S81–5PubMedCrossRefGoogle Scholar
- 26.Antonazas F, Forcen T, Garuz R. Analisis de cost-efectividad de la vacunacion frente al virus de la hepatite B. Med Clin Barc 1992; 99: 41–6Google Scholar
- 29.Garuz Bellido R, Torrea Hernandez JL, Arnal Alonso JM, et al. Vaccination against hepatitis B virus: a cost—effectiveness analysis. Vaccine. In pressGoogle Scholar