Australia was the first, in 1993, to make economic evaluation an important component of its decisions about reimbursement of drugs.  Since then, several jurisdictions have followed suit.  Decision-making authorities (e.g., ministries of health or health technology assessment agencies) usually issue methodological guidelines for the conduct of studies of economic value.  Similarities across countries in the sets of guidelines likely are greater than the differences, especially among those guidelines that have been developed in the context of formal decision-making procedures. Nevertheless, important differences do exist in key elements of methodology, such as the choice of comparator or how uncertainty is to be handled.  This raises the issue of whether it is possible to develop international standards for economic evaluation in health care.

This Briefing examines two recent sets of methodological guidance issued by agencies in two major European countries, NICE in the UK and IQWiG in Germany.  It assesses whether analysts are moving closer to the development of international standards in economic evaluation and what it would take to achieve this aim.