To carry out systematic literature review (SLR), Finnish applicability evaluation (FAE) and level of evidence evaluation (LoEE) based on the published health economic evaluations (HEE) of biologic psoriatic arthritis treatments as a part of the work for a national treatment guideline (Current Care Criteria [CCC] of psoriasis for Finland).
SLR included published articles or assessment reports available in Medline or Cochrane and fulfilling the PICOSTEPS (Patients, Intervention, Comparators, Outcomes, Settings, Time, Effects, Sensitivity) framework for an incremental cost effectiveness/utility, cost benefit, cost consequence, cost minimization, budget impact, willingness to pay, value of life or value of information analysis. FAE included sequential assessment of publications based on Pharmaceuticals Pricing Board, Consolidated Health Economic Evaluation Reporting Standards (CHEERS) and two earlier criteria. LoEE was built based on existing CCC classification (strong, moderate, minor/weak, no evidence) and extended significantly to cover HEEs.
41 publications fulfilled the search criteria and 15 publications were fully reviewed. In FAE, the most effort was used to assess the representativeness of patients, costs, quality of life and other inputs as well as modelling rationale for the Finnish setting. Generally, the applicability of foreign HEE results to the established Finnish CCC setting as such was poor and only one treatment had strong negative HEE evidence (multiple non-conflicting incremental HEE results). Most drugs had minor-to-moderate (one or conflicting) HEE evidence and three drugs had no valid HEE evidence. SLR, FAE and LoEE of HEEs was beneficial for the CCC.
PICOSTEPS formed a working basis for the structural inclusion criteria to carry out the SLR. FAE was done based on the guidelines and demonstrated that there is significant need for local HEEs, especially if the published HEEs are rare or poorly generalizable to Finland. LoEE is an important part of review and should conclude the SLR statements based on HEEs.
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