Element card for assessment element E0007 in HTA Core Model Application for Screening Technologies 1.0 application

E. Costs and economic evaluation

Cost-effectiveness

What is the appropriate time horizon?

Core

Both costs and effects should be modelled over an appropriate time horizon. In most curative interventions both costs and effects occur in a relatively short time period, while in screening the effects occur later in the future. Effectiveness data is rarely available for the whole appropriate time horizon and economic evaluation needs to link intermediate endpoints to final endpoints and/or extrapolate the effectiveness. Thus it is often argued that the effects are penalized by discounting and there is controversy on this issue. One needs to take into account any relevant official guidance when choosing specific discount rate for analysis. After that it is important to decide whether to discount both costs and effects, and whether to use uniform discount rate.

Critical
Partial

Effectiveness domain (effectiveness data may need extrapolation)

Guidelines for economic evaluation of Health Technologies: Canada, 3rd edition, 2006, Guidelines for Pharmacoeconomic Evaluations in Belgium, 2008