SENSITIVITY ANALYSIS IN HEALTH ECONOMIC AND PHARMACOECONOMIC STUDIES - AN APPRAISAL OF THE LITERATURE

The objective of this study was to analyse the extent of reporting of sensitivity analyses in the health economics, medical and pharmacy lit erature between journal types and over time. 90 articles were chosen f rom each of the bodies of literature on health economics, medicine and pharmacy. MEDLINE, EMBASE and International Pharmaceutical Abstracts were searched for English-language economic studies published between 1989 and 1993. The studies chosen for inclusion had to be original art icles published in one of the selected journals between January 1989 a nd December 1993, involving a comparison between drugs, treatments or services, and evaluating both costs and outcomes. 123 articles initial ly met these criteria; however, 16 were inappropriate, 17 were randomi sed out, leaving 90 studies (73%) that were used (30 from each literat ure group). Data were extracted independently by 5 raters using a vali dated checklist. Inter-rater reliability was assessed by calculating k appa. 53 of the 90 articles (59%) conducted sensitivity analyses. 39 ( 74%) stated explicitly that a sensitivity analysis was being performed ; this was noted in the Methods section of 35 papers (67%). 80% of hea lth economics journals, 70% of medical journals and 20% of pharmacy jo urnals conducted sensitivity analyses.Despite the fact that all publis hed pharmacoeconomic guidelines suggest the use of sensitivity analysi s, only 5% of studies between 1989 and 1993 did so. Improvement is req uired, especially in the pharmacy literature. No time trends in the co nduct of sensitivity analyses were detected. However, the sample may n ot have been sufficient to detect such trends. Pharmacoeconomic guidel ines should provide more details on preferred methods of sensitivity a nalysis and on desired parameters.