Table 1 Summary of methodological aspects reported in reviews of health economic analyses
Source | Area / Study type | Attribution of effects | Outcomes | Inter-sectoral costs | Equity |
|---|---|---|---|---|---|
Cochrane et al. (2019) [23] | Physical activity and sedentary behaviour interventions n = 15 CEA = 40% CUA = 33% Different types = 27% | TBA/MBA: n = 10/5 Time horizon all: - ≤ 2y: 67% - lifetime: 33% TBA: ≤ 2y 100% MBA: lifetime 100% | Intermediate HO: 53% HO/PbO: 60% (QALYs) Non-HO: 13% (e.g., absenteeism) | Categories: - labor/soc. security: 20% Perspective: - societal: 27% - health sector: 47% - not stated: 13% | Implicitly included via subgroup analyses: 93% (e.g., targeting the intervention to individuals in need of care) |
Reeves et al. (2019) [24] | Implementation of DPHP-interventions n = 14 CEA = 86% CUA = 7% CBA = 7% | TBA/MBA: n = 12/2 Time horizon all: - ≤ 2y: 43% - lifetime: 0% - not reported: 36% TBA: ≤ 2y 50% MBA: lifetime 0% | Intermediate HO: 93% HO/PbO: 29% (QALYS, life saved) Non-HO: 7% (violent crimes) | Categories: - education: 43% - labor/soc. security: 29% - criminal justice: 7% Perspective: - societal: 42% - not stated: 21% | n.a. |
Zanganeh et al. (2019) [30] | Childhood and adolescent obesity interventions n = 28 CEA = 36% CUA = 32% CCA = 4% Different types = 29% | TBA/MBA: n = 9/19 Time horizon all: - ≤ 2y: 21% - lifetime: 39% - not reported: 7% TBA: ≤ 2y 67% MBA: lifetime 58% | Intermediate HO: all studies (64%: BMI) HO/PbO: 59% (QALYs, DALYs) Non-HO: n.a. | Categories: - education: 4% - labor/soc. security: 57% - other: 18% Perspective: - societal: 84% - health sector: 8% - not stated: 8% | n.a. |
Huter et al. (2018) [25]a | DPHP-interventions for older people n = 8 CEA = 25% CUA = 25% Different types = 50% | TBA/MBA: n = 4/4 Time horizon all: - ≤ 2y: 75% - lifetime: 13% TBA: ≤ 2y 100% MBA: lifetime 25% | Intermediate HO: all studies (e.g., falls, physical activity) HO/PbO: 88% (fall-related fractures, QALYs) Non-HO: 13% (social benefits such as ‘general self-efficacy’, ‘well-being’, or ‘loneliness’) | Categories: − labor/soc. security: n.a. − household/leisure: n.a. − other: 13% Perspective: - societal: 13% - not stated: 88% | No adjustment for the preference structure of elderly in CUAs |
Oosterhoff et al. (2018) [26] | School-based lifestyle interventions n = 23 CEA = 48% CUA = 17% CBA = 9% SROI = 4% Different types = 22% | TBA/MBA: n = 9/14 Time horizon all: - ≤1y: 30% - lifetime: 43% TBA: ≤1y 78% MBA: lifetime 71% | Intermediate HO: 48% (weight-related measures or BMI) HO/PbO: 39% (QALYs or DALYs) Non-HO: 13% (school behaviour, wellbeing, outcomes to the household and leisure sector, environmental impacts and externalities, only in CBAs, SROI) | Categories: - education: 9% - labor/soc. security: 17% - household/leisure: 13% - other: 4% Perspective: - societal: 74% - healthcare: 13% - programs perspective: 4% - not stated: 9% | n.a. |
Dubas-Jakóbczyk et al. (2017) [27] | DPHP-interventions for older people N = 29 CCA = 7% CEA = 45% CUA = 10% CBA = 10% Different types = 28% | TBA/MBA: n = 19/10 Time horizon all: - ≤ 1y: 50% - lifetime: 17% TBA: ≤ 1y n.s MBA: lifetime n.s | Intermediate HO: 35% (falls, number of falls or fallers prevented) HO/PbO: 65% (changes in SF-36 physical functioning, LYG, daily functioning changes, QALYs) Non HO: 3% (e.g., social network) | Categories: - labor/soc. security: 3% - household/leisure: 21% - other: 7% Perspective: - societal: 41% - payer: 52% - unclear: 7% | Lack of economic evaluations for the prevention of mental health problems among the population 65+ |
Hill et al. (2017) [31] | Alcohol prevention n = 27 CEA = 22% CUA = 48% CBA = 4% CCA = 4% SROI = 4% Different types = 19% | TBA/MBA: n = 8/19 Time horizon all: - ≤1y: 19% − 1-5y: 26% - >30y to lifetime: 37% - not reported: 11% TBA: - ≤1y 50% MBA: - >30y to lifetime 53% | Intermediate HO: n.a HO/PbO: 67% (e.g., QALYs) Non HO: 0% | Categories: - education: 11% - labor/soc. security: 26% - household/leisure: 15% - criminal justice: 33% Perspective: - societal: 52% - health sector: 41% - other or not stated: 7% | Subgroup analysis for gender, age and alcohol intake |
Döring et al. (2016) [28] | Obesity prevention in early childhood N = 6 CCA = 17% CEA = 83% | TBA/MBA: n = 2/4 Time horizon all: - ≤2y: 33% - lifetime: 67% TBA: ≤2y 100% MBA: lifetime 100% | Intermediate HO: 100% (BMI, weight, behavioral changes) HO/PbO: 33% Non HO: n.a. | Categories: - labor/soc. security: 67% Perspective: - societal: 50% - other: 17% | n.a. |
Alayli-Goebbels et al. (2014) [5] | Behavior change interventions N = 142 CCA = 8% CEA = 48% CUA = 11% CMA = 3% CBA = 6% Different types = 25% | TBA/MBA: n = 58/56b Time horizon all: - ≤ 2y: 37% -lifetime: 21% - not reported: 22% TBA: ≤ 2y 83% MBA: lifetime in 38% (30/79 modelling and combined) | Intermediate HO: 61%: (behavior change, biomedical health indicators) HO/PbO: 52% (e.g., survival, HRQOL) Non HO: 9% (e.g., increased health knowledge) | Categories: - summarized: 8% (included costs of car accidents, violent crimes, personal injury, property damage, fire destruction, law enforcement, and costs to industry, commerce and the voluntary sectors) Perspective: - not stated: 43% | Explicitly considered by no study |
Polinder et al.(2012) [29] | Injury prevention N = 48 CEA = 38% CUA = 10% CBA = 35% Different types = 17% | TBA/MBA: n = 24/24 Time horizon all: - ≤ 5y: 33% - lifetime: 8% - not reported: 17% TBA: <2y 17% MBA: lifetime 16% | Intermediate HO: 10% (falls prevented) HO/PbO: 52% (injuries prevented, life saved, QALYs) Non HO: n.a. | Categories: - labor/soc. security: 23% - household/leisure: 2% Perspective: - societal: 69% - health care: 25% | n.a. |
Weatherly et al. (2009) [19] | DPHP-interventions in eleven public health areas N = 154 CCA = 37% CEA = 36% CUA = 27% CMA = 0% CBA = 0% | TBA/MBA: n = 106/48 Time horizon all: n.s. | Intermediate HO: n.s. (falls prevented, pounds lost) HO/PbO: 27% (QALYs, DALYs) Non HO: n. s. (quality of wellbeing, public preferences for the (dis) benefits of a water fluoridation program) | Categories: - education: 3% - labor/soc. security: 20% - household/leisure: 2% - criminal justice: 4% - other: 16% Perspective: - payer: 32% - societal: 31% - not stated: 24% | QALYs were not explicitly equity-weighted, some studies conducted equity-related sub-groups analyses |