TAKING INTO ACCOUNT ECONOMIC CRITERIA FOR THE CLINICAL-PRACTICE GUIDELINES IN ONCOLOGY

Clinical practice guidelines have been defined as ''systematically dev eloped statements to assist practitioners and patients in their decisi ons about appropriate health care for specific clinical circumstances' '. Their objectives are to improve the quality of health care and to o ptimise the use of limited health care resources. However reduction of unnecessary costs of delivered health care is proceed most often in a n implicit way by identifying inappropriate health care strategies. Th e increase of health rare costs needs to took at this issue in a more explicit way and to consider costs in the guideline development proces s. The key objective of our study is to analyse the methodological asp ects of dealing with cost issues in the guideline development process. The integration of cost issues is in fact limited by two major proble ms: first the lack of economic evaluation for many strategies in the s cientific literature and second, the lack of generalizability of the p ublished results to temporally and/or geographically different setting s. These difficulties are likely to result in the need for local cost evaluation (for a given setting), and though to make the guideline dev elopment process much more complex. Further methodological research is important to define the role of economic evaluation in clinical pract ice guidelines and to enable the integration of cost issues into the g uideline development process. They should go closely together with int ernational standardisation of the methodology for designing, conductin g and reporting economic evaluation.