Gebruik van point-of care systemen bij patiënten met orale ... - KCE

KCE Reports 117 POC Anticoagulation 69
6 ECONOMIC LITERATURE REVIEW
6.1 INTRODUCTION
In Belgium, the number of patients on long term anticoagulation therapy is substantial
(see chapter 7). Before a decision on the reimbursement of point-of-care (POC)
systems is taken, decision makers might wish to know whether the device offers ‘value
for money’. Value for money is typically assessed in economic evaluations. In this
chapter we review the literature on economic evaluations of POC systems compared to
usual care. We restricted our review to full economic evaluations, defined as analyses
comparing both costs and outcomes of at least two health care programs (definition
Drummond et al). 121
6.2 METHODS
6.2.1 Literature search strategy
Economic evaluations were sought from four sources:
• A search on MEDLINE, Psychinfo, and Econlit via “Ovid”
• A search on Embase
• A search via the “Cochrane Library” on the following databases: Cochrane
Database of Systematic Reviews, Cochrane Central Register of Controlled
Trials, Database of Abstracts of Reviews of Effects (DARE), NHS Economic
Evaluation Database (NHS EED) and Health Technology Assessment (HTA)
database
• Identification of studies from the bibliography of selected studies
The keywords used and the results are detailed in the appendix.
6.2.2 Selection criteria and method
This review focused on POC systems available in our country, i.e. CoaguChek, ProTime
microcoagulation, or INRatio. Thus, studies that did not consider at least one of these
POC systems were excluded.
Only full economic evaluations having a defined primary outcome and reviews of
economic evaluations were retained. Cost-outcome descriptions with multiple
outcomes were excluded. Partial analyses which focused only on the cost were also
excluded. Before exclusion, a rapid assessment showed that these rejected studies did
not give enough information to assess their quality or had a poor quality.
The search was limited to papers written in English, Dutch, French, Spanish, or German.
A first selection was based on titles and abstracts. Two health economists (SG-IC)
assessed abstracts for relevance. Full papers were obtained and assessed for all
potentially relevant studies.
6.2.3 Data extraction and quality assessment strategies
Data were extracted using a structured data extraction form and quality was assessed
by a single economist using a standard quality assessment checklist for economic
evaluations (see appendix to this chapter). The quality of studies was discussed
narratively.