BACKGROUND AND AIM Over 4 million people (8% of all deaths) worldwide die from traumatic injuries annually. For people aged 5-29 years, three of the top five causes of death are injury related, namely road traffic injuries, homicide, and suicide. Investments in injury care need to consider budget constraints, and economic evaluation studies can be employed to understand the costs and outcomes of competing interventions for injury care. However, these studies should be designed to meet the information requirements of decision makers. This systematic review aims to critically appraise the methodologies used in economic evaluations of injury care, assessing their suitability for informing decision-making. METHODS We conducted a global systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched six databases, from inception to June 2023, for eligible full economic evaluations of injury care. The primary population was persons who have suffered acute traumatic injuries. Only full economic evaluations were eligible for inclusion, and studies that met the inclusion criteria were appraised using the Consolidated Health Economic Evaluation Reporting Standards statement and critiqued against the decision-making guidelines developed by Sculpher et al. (2009). RESULTS A total of 259 studies were included in the final review. An overwhelming majority of the studies (92%) were conducted in high-income countries, and they predominantly evaluated in-hospital interventions (93% vs 1% pre-hospital and 6% post-discharge). Fractures were the most commonly studied injury type, while the provider perspective was the most frequent analytic perspective. We found that just over half of the studies synthesised effectiveness evidence from multiple sources; nearly a quarter of the studies compared more than two competing interventions; and 84% of the studies considered costs and outcomes over an appropriate time horizon. DISCUSSION We found key gaps in the existing evidence: limited synthesis of evidence to inform treatment effects, inadequate alignment of time horizons with intervention outcomes, geographic disparities in the scope and quality of evidence, and limited coverage across the full patient pathway. These limitations hinder the usefulness of study findings in decision-making. Future economic evaluations should address key gaps to improve the utility of economic evaluations in healthcare decision-making. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42022351978.
Janus kinase inhibitors (JAKi) are systemic therapies recommended by the National Institute for Health and Care Excellence (NICE) for moderate-to-severe atopic dermatitis (AD). However, no direct cost-effectiveness analyses of JAKi exist to guide decision-making. We evaluated the cost-effectiveness of abrocitinib versus upadacitinib and baricitinib in treating moderate-to-severe AD from a UK National Health Service (NHS) perspective. A decision tree captured short-term outcomes before patients transitioned to a Markov model (lifetime horizon; 1-year cycle length). Patients not responding (≥ 75
While health technology assessment (HTA) guides public funding decisions under uncertainty, existing research often examines individual methodological issues or high-level decision variation rather than how methodological choices interact throughout the appraisal process. Using immune checkpoint inhibitors (ICIs) in non‑small cell lung cancer (NSCLC) as a case study, this study examines how varying methodological choices shape cost‑effectiveness conclusions and reimbursement outcomes between National Institute for Health and Care Excellence (NICE) and Canada’s Drug Agency (CDA-AMC). Thirty‑five published technology appraisals from NICE and CDA‑AMC through February 2026 were reviewed using a prespecified, systematic approach. Extracted data included pivotal trial characteristics, comparator selection, cost‑effectiveness conclusions, and key modeling assumptions, including modeling methods, time horizon, utility values, survival extrapolation, treatment duration, effect waning, and cure. Overall concordance in cost‑effectiveness conclusions was 56.3
Peritoneal dialysis (PD) and haemodialysis (HD) are the principal initiating dialysis modalities for patients with kidney failure. Peritoneal dialysis is associated with early survival benefits, potential cost advantages and improved lifestyle flexibility; however, it is underutilised in the UK. This analysis aims to capture the benefits of initiating on PD compared with in-centre HD (ICHD) within UK National Health Service (NHS) practice using a cost–utility analysis (CUA) and budget impact analysis (BIA), supported by recently published UK and European renal registry data. The CUA employed a state-transition Markov model structure to capture the cost–utility of initiating dialysis with PD versus ICHD for incident people with kidney failure over a lifetime horizon. The model captured lifetime quality-adjusted life-years (QALYs) and costs to the NHS per treatment arm. The BIA employed a budget impact model (BIM) to capture the hypothetical budget impact of increasing annual uptake of PD and home haemodialysis (HHD) at equal rates relative to current practice, with the principal objective of reaching a 20
Numerous dengue early warning tools have been developed, while few have been successfully integrated into routine surveillance systems. The E-Dengue tool, designed using the “Useful, Usable, and Used” framework, aims to predict dengue epidemics three months in advance in the Mekong Delta Region (MDR) of Vietnam. This protocol outlines the economic evaluation of an early warning system in which E-Dengue alerts prompt proactive dengue prevention and control interventions. An economic evaluation using a societal perspective will be conducted alongside a cluster-randomized controlled trial. Costs and outcomes will be compared between the E-Dengue early warning system and routine practice. The primary outcome measure will be disability-adjusted life years (DALYs) and the secondary outcome measure will be dengue cases. The mean cost of a dengue case will be quantified by conducting a cost of illness substudy that will utilize both hospital billing records and structured surveys of patients and informal caregivers and by evidence synthesis from the literature. The cost-effectiveness of E-Dengue will be assessed over a 2-year time horizon and expressed as the incremental cost per DALY averted and per dengue case averted, respectively, and compared against a prespecified cost-effectiveness threshold. The robustness of the results will be evaluated using one-way and probabilistic sensitivity analyses. Demonstrating that E-Dengue is cost-effective will provide rigorous evidence to support its integration into routine surveillance in the MDR and potentially for it to be scaled up and adapted to other areas of Vietnam and nations with similar conditions. Conversely, if E-Dengue is not cost-effective, the study will provide critical lessons for the design and implementation of future early warning tools. Trial Registration no. ACTRN12626000402347.
