New Guidelines for Economic Evaluation in Germany and the United Kingdom are We Any Closer to Developing International Standards?

The last twenty years has seen a substantial growth in the literature on economic evaluation in health care. In addition, since Australia made economic evaluation an important component of its decision making process on the reimbursement of drugs in 1993, several jurisdictions have adopted economic evaluation as part of their formal decision-making procedures.In situations where economic evaluation is formally adopted, it is customary for the decision-making authority (e.g. Ministry of Health or health technology assessment agency) to issue methodological guidelines for the conduct of studies. As more and more sets of guidelines have been published, researchers have compared and contrasted the methodological guidance prescribed by the various jurisdictions (Hjelmgren et al., 2001; Tarn and Smith, 2006).The general conclusions of these assessments are that there are probably more similarities between the sets of guidelines than there are differences, especially among those guidelines that have been developed in the context of formal decision-making procedures. Nevertheless, Sculpher and Drummond (2006) point out that, despite the general similarities, there are important differences among guidelines in key elements of methodology, such as the choice of comparator (to the treatment of interest), or the ways in which uncertainty is to be handled