Table 5.

Antonanzas’ general and specific transferability index factors

Global index (IT)

General index (IT1)

Critical objective factors: The relevant parameters needed to calculate the ratio cost/effectiveness are given in the study. The quality of the study is acceptable: The study objectives are presented in a clear, specific, and measurable manner. The variable estimates used in the analysis come from the best available source. The measurement of cost is appropriate and the methodology for the estimation of quantity and unit costs is clearly described. The health outcome measures are based on valid and reliable scales, when available. Otherwise, the scales used in the study must be fully justified. The economic model (including its structure), study methods, and components of the costs and effectiveness are presented in a clear manner. The conclusions and recommendations for the study are justified and based on the study results. Noncritical objective factors:The codes as well as description of items are similar to those considered by Boulenger et al HT1. Is the intervention described in sufficient detail? HT2. Is the comparator described in sufficient detail? SE2. Is the country in which the economic study took place clearly specified? P1. Did the authors correctly state the perspective for the economic analysis? SP1. Is the target population of the health technology clearly stated or can it be inferred by reading the article? SP3. Does the article provide sufficient detail about the study sample? E5. Have the principal estimates of effectiveness measures been reported? E7. Are the results of a statistical analysis of the effectiveness results provided? B5. Is the level of reporting of benefit data adequate (incremental analysis, statistical analyses)? C1. Are the cost components used in the analysis presented? C5. Are unit price for resources given? C6. Are costs and quantities reported separately? C7. Is the price year given? C9. Is the currency unit reported? S1. Are quantitative and/or descriptive analyses conducted to explore variability from place to place? O1. Did the authors discuss the generalizability of their results?

Specific index (IT2)

Critical subjective factors: The evaluated technology is used in the new health context (This factor will not be taken into account if the economic evaluation is carried out to obtain relevant information before the potential use of the technology in the new context). The comparator is available or used in the new context. Treatment and comparator data, as well as relevant epidemiological parameters for the technology, are valid in the new context. The study perspective coincides with that used in the new context.

Noncritical subjective factors: Cost components correspond to the medical practice related to the evaluated technology in the original study. If medical practice differs in the new context, additional cost components must be taken into account. (For example, if in the original study all patients were explored with the CT-Scanner but in the new context, both MRI and CT-scanner are used: a new cost component should be included which can be unavailable). The model connecting variables and parameters can be adapted to the new context. Life expectancy is similar in both contexts. Health-status preferences are similar in both contexts. (Applicable to cost/utility analyses). Productivity measures are similar in both contexts (applicable to cost minimization and cost/benefit analysis). The evolution of the disease is similar in both contexts. The applied discount rate is similar in both contexts. Costs and health effects data are presented in current and discounted units.

Source: Antonanzas F, et al. Health Econ. 2009;18:629–643.