engleski

Incorporating the economic evidence in systematic reviews of interventions: an example from a systematic review in prophylaxis of respiratory syncytial virus infection

Background: In order to address economic issues within a systematic review (SR) of interventions, a SR of economic evaluation (EE) studies focusing on the same interventions might be carried out. The value of a SR of EEs is still open to debate. However, in some cases undertaking a SR of EEs is fundamental due to the economic impact that the new intervention could have, and the number of EE assessing its cost-effectiveness that are published. In those cases the synthesis of evidence will be more useful than that available from individual studies. Objectives: To describe methodological challenges of synthetizing the economic evidence, given the disparities across EEs, while performing a SR of interventions. To illustrate a coherent way of incorporating economic evidence into the SRs. Methods: Selection of studies, its critical appraisal and the data extraction from included studies was performed independently by two reviewers and disagreements were resolved by a third reviewer. Only full EE (cost-effectiveness/cost-utility analyses) were included. The quality was assessed using an adapted Drummond’s checklist. Characteristics and results of EEs were presented in a descriptive way in tables, separately for three subgroups, according to the baseline risk of population. The values of incremental cost-effectiveness ratios provided by authors were adjusted for the time value of money, by using the appropriate gross domestic product deflator, and were presented in 2011 EUR. Results: A total of 34 EE studies were included. The procedures undertaken for implementing the above mentioned methods in a SR assessing the effect of immunoprophylaxis in preventing the severe respiratory syncytial virus infection, will be presented. Conclusions: This example could be used as a guide to non-health economist reviewers within the Cochrane Collaboration, in terms of issues to be considered when undertaking a systematic review of economic evaluations as part of their SR of interventions.

systematic review; economic evaluation; cost-effectiveness

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