Methodological Characteristics in Economic Evaluations of Health Technology Assessment Reports Submitted for Drug Reimbursement in Brazilian Public Health

OBJECTIVES: To characterize methodological aspects and the quality reporting of economic evaluation in HTA reports of drugs submitted to the Brazilian public health system. METHODS: An electronic search for HTA reports focusing on drug incorporation into the public health system published between 2020 and June 2024 was conducted in the Conitec database. The study selection and data extraction were performed to obtain bibliographic data, base case characteristics, and methodological features. Furthermore, the quality reporting of economic evaluation was verified by the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022). Descriptive statistics summarize the data extracted from the documents. RESULTS: We included 188 economic evaluations of HTA reports about drug reimbursement; the great majority submitted to private companies or public institutions. Most economic evaluations adopted cost-utility or cost-effectiveness analysis using a comparator in the public system. Economic evaluation studies presented frequent inconsistent reports of cost and health outcomes and in the deterministic and probabilistic sensitivity analyses. Markov, decision tree, and partitioned survival model were the main mathematical models applied. Cost-effectiveness analysis mainly adopted QALY or QALY plus life-years gained as health outcomes, but there was a lack of clarity in the methods to incorporate health utilities in the cost-utility analysis. Finally, we identified that the quality reporting of economic evaluation needs to be improved. CONCLUSION: The methods and reporting quality of economic evaluations submitted to Conitec exhibit heterogeneity characteristics. Strengthening and standardizing guidance for preparing health economic evaluations is needed to ensure greater consistency, transparency, and decision-making reliability.