Systematic literature reviews (SLRs) in health care can broadly be classified into clinical and economic reviews. Economic systematic reviews mainly focus on economic evaluations and/or cost and health care resource use (HCRU). Rigorous guidelines for clinical SLRs and SLRs of economic evaluations exist; however, guidelines for cost and HCRU SLRs are lacking.
To outline a framework for conducting cost and HCRU SLRs.
Economic SLR guidelines were reviewed (e.g., NICE, 2015; Cochrane, 2011). Based on this literature, and our own expertise, we propose a framework for conducting SLRs of costs and HCRU: 1) Define review question: The SLR objective drives the nature of the review. The following should be defined: patient population (e.g., ≥ aged 18 years with type II diabetes, country), study perspective (e.g., payer, societal), study types (e.g., chart review, database analyses, hospital claims, survey, cost model), and time horizon for the review. 2) Determine search methods: Electronic databases that include cost and HCRU studies (MEDLINE, EMBASE, EconLit, the Cochrane Library including DARE, and HTAD) and conference websites not indexed in databases, current HTA documents and handsearching. 3) Data extraction: At a minimum, the following should be extracted: characteristics of included studies (e.g., year of study, country, definition of disease, number of patients, study design, time horizon, perspective, analyses method); results (e.g., cost year, currency, unit cost, number of units of resource use, costs of resource use, productivity loss, absenteeism). 4) Quality assessment: Critical appraisal must assess both methodological and reporting quality, as well as generalizability of a study. 5) Synthesize findings and present results: Results should be presented in a consistent currency and format for comparison, discussions may include heterogeneity within the data and generalizability of findings.
The proposed approach is a step toward a standardized method for conducting SLRs on cost and HCRU.
Framework for systematic review of cost and resource use studies