The fourth edition of the Guidelines for the Economic Evaluation of Health Technologies: Canada from the Canadian Agency for Drugs and Technologies in Health (CADTH), informs decisions made about who covers payment for medications, medical devices, and methods of treating and diagnosing Canadian patients. The guidelines set out the best practices for determining the economic value of health technologies, compared with existing approaches.

Since the previous update in 2006, the available methods of analyzing data have advanced, largely due to the exponential increase in computing power available to health economists. These new methods allow for more complex calculations that enable more refined estimates of costs and effects. These advances include probabilistic analysis, which accounts for the fact that any data going into an analysis come with a measurable level of uncertainty. Probabilistic analysis accounts for the uncertainty of information included, providing a more realistic sense about the accuracy of the estimate of cost-effectiveness. As a result, the new guidelines recommend that the extent of uncertainty must be considered, not just the resulting estimate. 

The updated guidelines also point to emerging areas to consider when determining the effectiveness of a new technology. These include the use of real-world data (such as the big data found in provincial administrative health databases), network meta-analysis (which uses existing studies to bring together a comparison of multiple technologies that haven’t been compared as a group in a clinical study), and new forms of clinical trials (such as adaptive clinical trials). 

The fourth edition was authored by a working group of Canadian health economists. CADTH also consulted with patient groups and industry to prepare the guidelines, and commissioned research to inform approaches to key topic areas and emerging issues. 

The Guidelines for the Economic Evaluation of Health Technologies: Canada, 4th Edition is available online at www.cadth.ca/healtheconomics [8].