A systematic review of discounting in national health economic evaluation guidelines: healthcare value implications

Abstract

Aim: This review summarizes the discounting approaches recommended in current economic evaluation (EE) guidelines for healthcare programs and interventions. Materials & methods: A systematic review of EE guidelines for healthcare, published up to July 2022, was conducted. Results: A total of 52 EE guidelines were reviewed. The majority of these guidelines recommend equal discounting (80.8%) rather than differential discounting (9.6%). The rationale for equal discounting includes recommendations by the government, consistencywith other countries, and economic development. However, the rationale for differential discounting is based on the interest in short-term government bonds and anticipated budget changes. Discussion: This review demonstrates variation in both discounting approaches and rates across EE guidelines and underscores the need for a global consensus on discounting approaches.

Keywords

• cost–effectiveness analysis
• decision making
• discounting
• economic evaluation
• health economics
• health technology assessment
• practice guidelines