In the context of ever-growing health expenditure and limited resources, economic evaluations aid in making evidence-informed policy decisions. Cost utility analyses (CUA) are often used in this context, but limitations include pairwise contrasts, missing contrasts, and different sources or quality of data.
Synthesis of CUA data from multiple studies is therefore desirable to assist policy makers, but there are many challenging methodological issues including: inconsistent reporting of results using different economic parameters, and multiple sources of heterogeneity including: setting, time horizon, perspective, modelling approaches and assumptions, currency, willingness to pay (WTP) threshold, level of country income, and input parameters. In this paper, we provide a step by step description of the methods for data harmonisation and synthesis of aggregated data from CUA studies, as well as a framework for handling heterogeneity; we demonstrate these methods using the example of agents for type 2 diabetes.
These meta-analytic methods for the synthesis of economic evidence synthesis should be useful for policy makers.