Health economics checklist (for BMJ)
Accessed from the BMJ website http://resources.bmj.com/bmj/authors/checklists-forms/healtheconomics on the 10th June 2011.
Item
number
Item
Page
number
Notes
Study design
(1)
The research question is stated.
3
(2)
3
The economic analysis assessed the
relative cost-effectiveness of adding
acupuncture sessions to usual care
compared with usual care alone for the
treatment of IBS.
There is insufficient evidence to
determine whether acupuncture is an
effective treatment for IBS, and no
evidence of cost-effectiveness from an
NHS perspective.
As above.
The UK NHS perspective was taken
where only costs directly linked to the
NHS budget were included
A Cochrane review supports the
finding that conventional treatments
for IBS are rarely effective in
managing all of the symptoms
associated with IBS. Hence, there is a
tendency of patients increasingly
turning to complementary and
alternative medicine, one of them
being acupuncture.
The treatment course of the
acupuncture arm included up to 10
sessions over a three month period.
The economic importance of the
research question is stated.
(3)
The viewpoint(s) of the analysis
3
are clearly stated and justified.
(4)
The rationale for choosing the
3
alternative programmes or
interventions compared is stated
(5)
The alternatives being compared
4
are clearly described
(6)
The form of economic
4
evaluation used is stated
(7)
The choice of form of economic
evaluation is justified in relation
to the questions addressed
3,4
Reader is directed to the
accompanying clinical paper for more
details
A cost-utility analysis approach was
adopted.
IBS is a condition that has potentially
substantial influence on quality of life,
so QALYs are an appropriate outcome
measure and cost-utility analysis the
appropriate form of evaluation.
Data collection
(8)
The source(s) of effectiveness
4
estimates used are stated
(9)
Details of the design and results
4
of effectiveness study are given
(if based on a single study)
(10)
Details of the method of
Utility data were based on the EQ-5D
questionnaire collected at threemonthly intervals from baseline to one
year.
Reader is directed to the
accompanying clinical paper that
provides more details of the trial
design and clinical results.
Also, “the clinical study, of which this
economic evaluation was part, was a
pragmatic randomised controlled trials
of acupuncture for IBS, carried out in
five general practices in North
Yorkshire.”
NA
synthesis or meta-analysis of
estimates are given (if based on
an overview of a number of
effectiveness studies)
(11)
The primary outcome
4
The outcomes of the analysis are
presented as incremental costs per
additional QALY.
4
Utility data were based on the EQ-5D
questionnaire collected at threemonthly intervals from baseline to one
year.
4
EQ-5D scores were converted to
“utility” scores by using the social
tariff based on preferences of the UK
general population
measure(s) for the economic
evaluation are clearly stated
(12)
Methods to value health states
and other benefits are stated
(13)
Details of the subjects from
NA
whom valuations were obtained
are given
(14)
Productivity changes (if
NA
included) are reported separately
(15)
The relevance of productivity
NA
changes to the study question is
discussed
(16)
Quantities of resources are
4-5
Under section “Resource use”
reported separately from their
unit costs
(17)
Methods for the estimation of
4-5
Under sections
1. Resource use data and outcome
measures
2. Unit costs
4,
13
The price year is 2010.
Table 1
quantities and unit costs are
described
(18)
Currency and price data are
recorded
(19)
Details of currency of price
NA
adjustments for inflation or
currency conversion are given.
(20)
Details of any model used are
NA
given
(21)
The choice of model used and
NA
the key parameters on which it is
based are justified
Analysis and interpretation of results
(22)
Time horizon of costs and
4
benefits is stated
(23)
The discount rate(s) is stated
NA
(24)
The choice of rate(s) is justified
NA
(25)
An explanation is given if costs
4
or benefits are not discounted
(26)
Details of statistical tests and
5-6
The time frame of the analysis was
one year.
The time frame of the analysis was
one year; hence no discounting was
applied to costs or outcomes
Under section “Analysis”
confidence intervals are given
for stochastic data
(27)
The approach to sensitivity
5-6
analysis is given
(28)
The choice of variables for
NA
sensitivity analysis is justified
(29)
The ranges over which the
variables are varied are stated
NA
An additional analysis was conducted
by multiple imputation for missing
EQ-5D and cost values.
The sensitivity analysis was based on
“imputing missing values” while the
base case analysis was based on
“complete cases”.
(30)
Relevant alternatives are
8-9
Under section “Cost-effectiveness”
compared
(31)
Incremental analysis is reported
8-9
Under section “Cost-effectiveness”
(32)
Major outcomes are presented in
15,
16
Table 3
Table 5
a disaggregated as well as
aggregated form
(33)
The answer to the study question 9
Under section “Principal findings”
is given
(34)
11
Under section “Conclusions”
Conclusions are accompanied by 10
Under section “Strengths and
weaknesses”
Conclusions follow from the
data reported
(35)
the appropriate caveats