To review the scope of countries, diseases, technologies and methods involved in the health economic evaluations published in the Middle East and North Africa (MENA) region. PRISMA guidelines were followed. A Pubmed search was conducted up to 15th December 2019. English language full-text articles were included if they reported original research on humans, involved the local population from Algeria, Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Syria, Tunisia, United Arab Emirates or Yemen, reported costs and involved a full or partial health economic analysis comparing alternative health technologies. Data on publication year, country of origin, disease area according to ICD-10, type of health technology, and applied methods were extracted. Our search yielded 1646 citations of full-text English articles, out of which 105 were eligible for our study. 57% of the studies were published after 2014, and 77% after 2009. The first study was published in 1989. 85% were single-country studies, 12% also involved non-MENA countries. All involved countries participated in at least one study, with Egypt (22%), Saudi Arabia (20%), Jordan (7%) being most active. Most studies focused on infectious diseases (27%), followed by diseases of the digestive system (8%), genitourinary system (8%) and circulatory system (8%). The health technology was a system in 41%, medicine in 30%, vaccine in 11%, device in 10% and procedure in 9%. The method was full economic evaluation in 50%, partial economic evaluation in 27%, and efficacy trial reporting costs in 21% of studies, while 3% involved other methods. 56% of studies were trial-based, 42% were model-based and 2% were econometric analyses. The corresponding author was affiliated to a MENA country in 62% of publications. The diverse health economic literature reflected the characteristics of health systems and health challenges of the MENA region.
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