Methods: We searched the official website of IDSA to identify current guidelines and determined the percentage of guidelines that referenced cost analyses in their recommendations. We also performed PubMed database search with the term used in the retrieved guidelines to identify cost analyses that were relevant to the guidelines. Finally, we designed a 1:1 case-control study to compare included (cases) and not included (controls) cost analyses matched by study subject, in terms of items requested in the CHEERS statement, as well as the impact factor of the publishing journal and the year of publication.
Results: Forty IDSA guidelines were identified, among which 25 (62.5%) included at least 1 cost analysis in their reasoning. IDSA guidelines were found to incorporate 13.3% (95% CI, 8.5%-18.9%) of the 1,068 available cost analyses retrieved from PubMed. In the case-control study, the mean number of items of the CHEERS statement fulfilled by cases was 14.9 (SD=4.14) comparable to the 14.2 of controls (SD=4.25) (p=0.19). In the itemized comparison, cases were more likely to directly relate their economic outcomes with healthcare outcomes for patients (82% vs. 64% respectively) and that was the only significant difference identified (p=0.04). The mean impact factor of the publishing journal for cases was 8.18, higher than the mean 5.75 for controls, but the difference did not reach statistical significance (p=0.09). The year of publication of cases and controls did not differ (p=0.98).
Conclusion: The majority of IDSA guidelines use cost analyses to support their recommendations. Over 10% of PubMed identified relevant cost analyses were deemed appropriate for inclusion in guidelines by authoring committees, with an identified advantage of cost analyses that directly related cost data with healthcare outcomes for patients.
E. Pliakos, None
E. Mylonakis, T2 biosystems: Grant Investigator , Research grant
Astellas Pharma: Board Member and Grant Investigator , Consulting fee and Grant recipient
Boehringer Ingelheim: Grant Investigator , Research grant
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