ArticleBMC health services research2026
Incorporating economic considerations in clinical practice guideline development: a scoping review.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundIntegrating economic evidence into clinical practice guideline (CPG) development is key to optimally allocating finite healthcare resources. Economic analysis contributes to decisions that enhance population health by investing in effective and affordable care. However, the absence of an accepted approach for using economic evidence to guide decisions in CPGs is challenging. This study, part of the Global Evidence, Local Adaptation (GELA) project in Malawi, Nigeria, and South Africa, examines and summarises available methodological guidance in the literature for including economic evidence in CPG development.
methodsWe searched MEDLINE (via PubMed), World Health Organization (WHO), and Guideline International Network (GIN) libraries from 2013 to 2023 for English-language guidance documents that provided methodological recommendations on integrating economic evidence in CPG development. We also searched ten websites of key guideline development institutions, professional societies, and health technology assessment agencies. Drawing on the various recommendations in eligible guidance documents, we present a summary of suggested approaches.
resultsWe identified 168 guidance documents; after excluding 151 and assessing 17 full-text documents, eight were eligible. Available guidance was categorised into four key processes: assessing the need for economic evidence, defining priorities, outlining the scope of the analysis, and assessing the evidence. Key methodological challenges identified included managing the nuances of building whole disease models and using results from economic evaluations with differing underlying assumptions to inform recommendations. We also identified critical actions for incorporating economic evidence in final guideline recommendations in three areas: methods, presentation of results, and the judgment of cost-effectiveness.
conclusionA transparent and structured process for integrating economic evidence into guideline recommendations is essential for ensuring the relevance of decisions to the implementation context and enhancing confidence in the process. Our findings may support healthcare professionals, guideline developers, health economists, and policymakers involved in CPG development. CLINICAL TRIAL NUMBER: Not applicable.
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