Exploring the Generalizability of Foreign Cost-Effectiveness Analysis to Spain Using Data From a Scoping Review of Multinational Studies

Serrano-Aguilar P, Asua-Batarrita J, Molina-López MT, Espallargues M, Pons-Rafols J, García-Armesto S, et al. The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS). Int J Technol Assess Health Care. 2019;35:176–80.

Article  PubMed  Google Scholar 

European Parliament - Council of the European Union. Regulation (EU) 2021/2282 of the European Parliament and of the Council of 15 December 2021 on health technology assessment and amending Directive 2011/24/EU (Text with EEA relevance). Official Journal of the European Union; 2021.

Fontrier A-M, Visintin E, Kanavos P. Similarities and differences in health technology assessment systems and implications for coverage decisions: evidence from 32 countries. Pharmacoeconomics. 2022;6:315–28.

Article  Google Scholar 

Drummond MF, Sculpher M, Torrance G, O’Brien B, Stoddart G. Methods for the economic evaluation of health care programmes. 3rd ed. New York: Oxford University Press; 2005.

Book  Google Scholar 

Nelson AL, Cohen JT, Greenberg D, Kent DM. Much cheaper, almost as good: decrementally cost-effective medical innovation. Ann Intern Med. 2009;151:662. https://doi.org/10.7326/0003-4819-151-9-200911030-00011.

Article  PubMed  Google Scholar 

Vallejo-Torres L, García-Lorenzo B, Castilla I, Valcárcel-Nazco C, García-Pérez L, Linertová R, et al. On the estimation of the cost-effectiveness threshold: why, what, how? Value Health. 2016;19:558–66.

Article  PubMed  Google Scholar 

Vallejo-Torres L, García-Lorenzo B, Serrano-Aguilar P. Estimating a cost-effectiveness threshold for the Spanish NHS. Health Econ. 2017;27(4):746–61.

Article  PubMed  Google Scholar 

Vallejo-Torres L. Estimating the incremental cost per QALY produced by the Spanish NHS: a fixed-effect econometric approach. Pharmacoeconomics. 2025;43:109–22.

Article  PubMed  Google Scholar 

Oliva-Moreno J, Puig-Junoy J, Trapero-Bertran M, Epstein D, Pinyol C, Sacristán JA. Economic evaluation for pricing and reimbursement of new drugs in Spain: fable or desideratum? Value Health. 2020;23:25–31.

Article  PubMed  Google Scholar 

Ginsberg GM. Generalizability of cost-utility analyses across countries and settings. Best Pract Res Clin Gastroenterol. 2013;27:845–52.

Kaló Z, Landa K, Doležal T, Vokó Z. Transferability of National Institute for Health and Clinical Excellence recommendations for pharmaceutical therapies in oncology to Central-Eastern European countries. Eur J Cancer Care (Engl). 2012;21:442–9.

PubMed  Google Scholar 

Drummond M, Barbieri M, Cook J, Glick HA, Lis J, Malik F, et al. Transferability of economic evaluations across jurisdictions: ISPOR good research practices task force report. Value Health. 2009;12:409–18.

Article  PubMed  Google Scholar 

Anderson R. Systematic reviews of economic evaluations: utility or futility? Health Econ. 2010;19:350–64.

Article  PubMed  Google Scholar 

Goeree R, He J, O’Reilly D, Tarride J-E, Xie F, Burke. Transferability of health technology assessments and economic evaluations: a systematic review of approaches for assessment and application. ClinicoEcon Outcomes Res. 2011;3:89-104.

Barbieri M, Drummond M, Rutten F, Cook J, Glick HA, Lis J, et al. What do international pharmacoeconomic guidelines say about economic data transferability? Value Health. 2010;13:1028–37.

Article  PubMed  Google Scholar 

Barbieri M, Drummond M, Willke R, Chancellor J, Jolain B, Towse A. Variability of cost-effectiveness estimates for pharmaceuticals in Western Europe: lessons for inferring generalizability. Value Health. 2005;8:10–23.

Article  PubMed  Google Scholar 

Boehler CEH, Lord J. Mind the gap! A multilevel analysis of factors related to variation in published cost-effectiveness estimates within and between countries. Med Decis Mak. 2016;36:31–47.

Article  Google Scholar 

Mandrik LO, Severens HJL, Bardach A, Ghabri S, Hamel C, Mathes T, et al. Critical appraisal of systematic reviews with costs and cost-effectiveness outcomes: an ISPOR good practices task force report. Value Health. 2021;24(4):463–72.

Article  PubMed  Google Scholar 

Mathes T, Walgenbach M, Antoine SL, Pieper D, Eikermann M. Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature. Med Decis Mak. 2014;34:826–40.

Shemilt I, Mugford M, Byford S, Drummond M, Eisenstein E, Knapp M, et al. Chapter 15: Incorporating economics evidence. In: Higgins J, Green S, editors. Cochrane handbook for systematic reviews of interventions version 500 (updated February 2008). The Cochrane Collaboration; 2008.

Weise A, Büchter RB, Pieper D, Mathes T. Assessing transferability in systematic reviews of health economic evaluations—a review of methodological guidance. BMC Med Res Methodol. 2022. https://doi.org/10.1186/s12874-022-01536-6.

Article  PubMed  PubMed Central  Google Scholar 

Heupink LF, Peacocke EF, Sæterdal I, Chola L, Fronsdal K. Considerations for transferability of health technology assessments: a scoping review of tools, methods, and practices. Cambridge: Int J Technol Assess Health Care. Cambridge University Press; 2022.

Google Scholar 

López Bastida J, Oliva J, Antoñanzas F, García-Altés A, Gisbert R, Mar J, et al. Propuesta de guía para la evaluación económica aplicada a las tecnologías sanitarias. Plan Nacional para el SNS del MSC. Servicio de Evaluación del Servicio Canario de la Salud; 2008.

Puig Junoy J, Oliva Moreno J, Trapero Bertrán M, Abellán Perpiñán JM, Brosa Riestra M. Guía y recomendaciones para la realización y presentación de evaluaciones económicas y análisis de impacto presupuestario de medicamentos en el ámbito del CatSalut. 1.0. Servei Català de la Salut (CatSalut), editor. Barcelona: Generalitat de Catalunya, Departament de Salut; 2014.

Ortega Eslava A, Marín Gil R, Fraga Fuentes MD, López-Briz E, Puigventós Latorre F. Guía de evaluación económica e impacto presupuestario en los informes de evaluación de medicamentos. Guía práctica. Sociedad Española de Farmacia Hospitalaria; 2016.

Comité Asesor para la Financiación de la Prestación Farmacéutica del Sistema Nacional de Salud. Guía de evaluación económica de medicamentos. 2023.

Trapero-Bertran M, Oliva J, Catalá-López F, García-Pérez L, Segú L, Alegre-del-Rey EJ, et al. Guideline for the economic evaluation of medicines: a proposal by the Spanish National Health System’s Advisory Committee for pharmaceutical financing. Gac Sanit. 2025;39:102448.

Article  PubMed  Google Scholar 

López Bastida J, Oliva J, Antoñanzas F, García-Altés A, Gisbert R, Mar J, et al. Propuesta de guía para la evaluación económica aplicada a las tecnologías sanitarias. Gac Sanit. 2010;24:154–70.

Article  PubMed  Google Scholar 

Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.

Book  Google Scholar 

EUnetHTA Joint Action 2, Work Package 7, Subgroup 3, Heintz E, Gerber-Grote A, Ghabri S, Hamers FF, Rupel VP, et al. Is there a European view on health economic evaluations? Results from a synopsis of methodological guidelines used in the EUnetHTA partner countries. Pharmacoeconomics. 2016;34:59–76.

Article  Google Scholar 

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169:467–73.

Article  PubMed  Google Scholar 

World Bank. World Bank Country and Lending Groups [Internet]. 2020 [cited 2020 Jul 27]. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups%0A.

Welte R, Feenstra T, Jager H, Leidl R. A decision chart for assessing and improving the transferability of economic evaluation results between countries. Pharmacoeconomics. 2004. https://doi.org/10.2165/00019053-200422130-00004.

Article  PubMed  Google Scholar 

Vallejo-Torres L, García-Lorenzo B, Rivero-Arias O, Pinto-Prades JL, Serrano-Aguilar P. Disposición a pagar de la sociedad española por un Año de Vida Ajustado por Calidad. Ministerio de Sanidad, Servicios Sociales e Igualdad. Servicio de Evaluación del Servicio Canario de la Salud; 2016.

Goldstein H. Multilevel statistical models. New York: Wiley; 2010.

Book  Google Scholar 

Shields GE, Pennington B, Bullement A, Wright S, Elvidge J. Out of date or best before? A commentary on the relevance of economic evaluations over time. Pharmacoeconomics. 2022;40:249–56.

Article  PubMed  Google Scholar 

Vallejo-Torres L, García-Lorenzo B, Edney LC, Stadhouders N, Edoka I, Castilla-Rodríguez I, et al. Are estimates of the health opportunity cost being used to draw conclusions in published cost-effectiveness analyses? A scoping review in four countries. Appl Health Econ Health Policy. 2022;20:337–49.

Article  PubMed  Google Scholar 

Angulo JC, Valpas A, Rejas J, Linden K, Kvasz M, Snedecor SJ. Cost effectiveness of fesoterodine and tolterodine for the treatment of overactive bladder with urge urinary incontinence in Spain and Finland. Clin Drug Investig. 2014;34:297–307.

Article  PubMed  Google Scholar 

Annemans L, Lamotte M, Kubin M, Evers T, Verheugt FWA. Which patients should receive aspirin for primary prevention of cardiovascular disease? An economic evaluation. Int J Clin Pract. 2006;60:1129–37.

Article  CAS  PubMed  Google Scholar 

Anselmino M, Bammer T, Fernández Cebrián JM, Daoud F, Romagnoli G, Torres A. Cost-effectiveness and budget impact of obesity surgery in patients with type 2 diabetes in three European countries(II). Obes Surg. 2009;19:1542–9.

Article  PubMed  Google Scholar 

Banz K, Delnoy PP, Billuart JR. Exploratory cost-effectiveness analysis of cardiac resynchronization therapy with systematic device optimization vs. standard (non-systematic) optimization: a multinational economic evaluation. Health Econ Rev. 2015;5:1–10.

Article  Google Scholar 

Borgström F, Carlsson Å, Sintonen H, Boonen S, Haentjens P, Burge R, et al. The cost-effectiveness of risedronate in the treatment of osteoporosis: an international perspective. Osteoporos Int. 2006;17:996–1007.

Article  PubMed  Google Scholar 

Borgström F, Ström O, Kleman M, McCloskey E, Johansson H, Odén A, et al. Cost-effectiveness of bazedoxifene incorporating the FRAX® algorithm in a European perspective. Osteoporos Int. 2011;22:955–65.

Article  PubMed  Google Scholar 

Bourbeau J, Granados D, Roze S, Durand-Zaleski I, Casan P, Köhler D, et al. Cost-effectiveness of the COPD patient management European trial home-based disease management program. Int J COPD. 2019;14:645–57.

Article  Google Scholar 

Brüggenjürgen B, Reinhold T. Cost-effectiveness of grass pollen subcutaneous immunotherapy (SCIT) compared to sublingual immunotherapy (SLIT) and symptomatic treatment in Austria, Spain, and Switzerland. J Med Econ. 2018;21:374–81.

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