PHP244 - Cost Minimisation Analysis: When And Where? A Review Of Hta Guidance On Cost Minimisation Analysis

Abstract

Cost minimisation analysis (CMA) is a form of economic evaluation advocated in cases where products have equal efficacy. Whilst there is consensus on this point, the criteria for establishing equal efficacy varies by source. Additionally, the availability of guidelines on the acceptability of CMA is not always available from HTA bodies. This study reviewed HTA guidelines to determine: 1) if guidelines on the use of CMA are available; and 2) how consistent requirements are between HTA bodies. Searches of 10 HTA body websites were undertaken. The following terms were applied: ‘cost-minimisation’ or ‘cost minimisation’ or ‘cost-minimization’ or ‘cost minimization’. Additionally, available guidelines on HTA methods were reviewed. Results were hand searched to identify those reporting methods for CMA. Where guidelines was reported the definition of equal efficacy was extracted. Of the 10 HTA websites reviewed seven had readily accessible details on CMA. In two instances this was simply a definition of CMA whilst the remaining five provided details of where CMA is considered an appropriate methodology. Of these there were two common definitions, those that focused purely on clinical efficacy and those that broadened the definition to include patient outcomes in addition to clinical outcomes. Only the guidelines published by PBAC in Australia reported detailed criteria for meeting clinical equivalence. This review aimed to identify availability of guidelines on CMA methodology. Three bodies did not report any information, although in the case of some this may be driven by the nature of the products assessed. Where details were given there was a lack of consistency in the criteria for CMA, with the issue of whether only considering clinical efficacy or also incorporating broader patient outcomes needing consistency. Finally, the exact criteria for equivalence were only stated by PBAC.