OMERACT 6 Economics Working Group Report: A Proposal for a Reference Case for Economic Evaluation in Rheumatoid Arthritis

SHERINE GABRIEL, MICHAEL DRUMMOND, ANDREAS MAETZEL, MAARTEN BOERS, DOUG COYLE, VIVIAN WELCH, and PETER TUGWELL

ABSTRACT.

Standardization of methods for economic evaluation is essential for defining the methodological research agenda that will advance the discipline. Standardization also greatly facilitates the interpretation and comparison of the results of economic analyses. For these reasons, several jurisdictions now require economic evaluation, conducted according to standardized methodological guidelines, as a key ingredient in decision making for reimbursement of health treatments and technologies. The application of these general guidelines, however, can be difficult in the absence of disease-specific information. In the case of rheumatoid arthritis (RA), the recent emergence of innovative, highly effective, but also expensive treatments has created an immediate need to more fully understand the economic implications of RA treatments. With this background, the OMERACT Economics Working Group set out in 1994 to develop an RA-specific reference case for economic evaluation. This report summarizes the OMERACT process leading to specific recommendations on the 12 key elements of a proposed "reference case" for economic evaluation in RA. These elements include: study horizon, duration of therapy, extrapolation beyond trial duration, modeling beyond therapy, synthesis of comparisons where head-to-head trials do not exist, clinical outcome measures, mortality, valuation of health states, resource utilization, discontinuation of therapy, therapeutic sequence, and population risk stratification. Through these efforts, the OMERACT Economics Working Group aims to expedite and enhance the conduct and dissemination of methodological research in economic analyses in the rheumatic diseases. (J Rheumatol 2003;30:886-90)

Key Indexing Terms:

ECONOMIC EVALUATION
OMERACT
REFERENCE CASE

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From the Department of Health Sciences Research and Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA; Centre for Health Economics, University of York, York, UK; Division of Clinical Decision Making and Health Care Research, Toronto General Research Institute, Toronto, Canada; Department of Clinical Epidemiology and Biostatistics, VU University Hospital, Amsterdam, The Netherlands; Clinical Epidemiology Unit, Loeb Research Institute, Ottawa Hospital; and the Centre for Global Health, University of Ottawa, Institute of Population Health, Ottawa, Canada.

S. Gabriel, MD, MSc, Department of Health Sciences Research and Division of Rheumatology, Department of Internal Medicine, Mayo Clinic; M. Drummond, PhD, Center for Health Economics, University of York; A. Maetzel, MD, MSc, PhD, Division of Clinical Decision Making and Health Care Research, Toronto General Research Institute; M. Boers, MD, MSc, PhD, Department of Clinical Epidemiology and Biostatistics, VU University Hospital; D. Coyle, MD, Clinical Epidemiology Unit, Loeb Research Institute; V. Welch, Centre for Global Health, Institute of Population Health; P. Tugwell, MD, MSc, Clinical Epidemiology Unit, Loeb Research Institute.

Address reprint requests to Dr. S.E. Gabriel, Department of Health Sciences Research, Mayo Clinic, 200 First St. SW, Rochester, MN 55905.

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