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A Systematic Review on Economic Evaluation Studies of Diagnostic and Therapeutic Interventions in the Middle East and North Africa

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Abstract

Introduction

Due to the increase in healthcare budget constraint, economic evaluation (EE) evidence is increasingly required to inform resource allocation decisions. This study aimed to systematically review quantity, characteristics, and quality of full EE studies on diagnostic and therapeutic interventions conducted in 26 Middle East and North Africa (MENA) countries.

Methods

PubMed and Scopus databases were comprehensively searched to identify the published EE studies in the MENA region. The quality of reviewed studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.

Results

The search identified 69 studies. The cost-utility approach was adopted in 49 studies (71 %). More than half (38 studies; 55 %) were conducted in Iran and Turkey. Sixteen countries (62 %) did not have any EE studies. The most frequently analyzed therapeutic areas were infectious diseases (19 studies; 28 %), cardiovascular diseases (11 studies; 16 %), and malignancies (10 studies; 14 %). Ten studies (14 %), 46 (67 %), 12 (17 %), and 1 study (1 %) were classified as excellent, high, moderate, and poor quality, respectively. The mean of items reported was 85.10 % (standard deviation 13.32 %). Characterizing heterogeneity, measurement of effectiveness, time horizon, and discount rate were missed in 21 (60 %), 22 (32 %), 20 (29 %) and 15 (25 %) studies, respectively. Data on effectiveness and utility relied primarily on studies conducted outside the region.

Conclusions

The quantity of EE studies in the MENA region remains low; however, overall quality is high to excellent. The availability of local data, capacity building, and national guidelines are vital to improve both the quantity and quality of EE studies in the region.

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Acknowledgements

This work was part of the training of Mouaddh Abdulmalik Nagi at Social, Economic and Administrative pharmacy graduate program at Mahidol University. The authors would like to gratefully acknowledge Health Technology Assessment international (HTAi), Alberta—Canada and Mahidol University for their generous support of this training. The findings, interpretations and conclusions expressed in this article do not necessarily reflect the views of the aforementioned supporting agencies.

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Authors and Affiliations

  1. Doctor of Philosophy Program in Social, Economic, and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand

    Mouaddh Abdulmalik Nagi & Pramitha Esha Nirmala Dewi

  2. Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen

    Mouaddh Abdulmalik Nagi

  3. Department of Pharmacy Profession, Faculty of Medicine and health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia

    Pramitha Esha Nirmala Dewi

  4. Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, 10400, Thailand

    Montarat Thavorncharoensap

  5. Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, 10400, Thailand

    Sermsiri Sangroongruangsri

Authors
  1. Mouaddh Abdulmalik Nagi
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  2. Pramitha Esha Nirmala Dewi
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  3. Montarat Thavorncharoensap
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  4. Sermsiri Sangroongruangsri
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Corresponding author

Correspondence to Mouaddh Abdulmalik Nagi.

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Funding

The authors received no financial support for this research.

Conflict of Interest

Mouaddh Abdulmalik Nagi, Pramitha Esha Nirmala Dewi, Montarat Thavorncharoensap, and Sermsiri Sangroongruangsri declare that they have no conflict of interest.

Ethical Approval

Ethical approval is not required for this study since it does not include human subjects.

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Not applicable.

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Not applicable.

Availability of Data and Material

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Author Contribution

All authors attest they meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MAN, MT, SS and PEND. The first draft of the manuscript was written by MAN. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Nagi, M.A., Dewi, P.E.N., Thavorncharoensap, M. et al. A Systematic Review on Economic Evaluation Studies of Diagnostic and Therapeutic Interventions in the Middle East and North Africa. Appl Health Econ Health Policy 20, 315–335 (2022). https://doi.org/10.1007/s40258-021-00703-y

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