The first edition of the Guidelines for Economic Evaluation of Pharmaceutic
al: Canada was published in November 1994. At that time, the Canadian Coord
inating Office for Health Technology Assessment (CCOHTA) was assigned the t
ask of maintaining and regularly updating the Canadian Guidelines.
Since their introduction, a great deal of experience has been gained with t
he practical application of the guidelines. Their role has also evolved ove
r time, from being a framework for pharmacoeconomic research to the point w
here a wide variety of decision-makers use economic evaluations based on th
e principles set out in the guidelines as a means of facilitating their for
mulary decisions, In addition, methodologies in certain areas (and the body
of related research literature in general) have developed considerably ove
r time. Given these changes in the science and the experience gained, CCOHT
A convened a multi-disciplinary committee to address the need for revisions
to the guidelines. The underlying principles of the review process were to
keep the guidance nature of the document, to focus on the needs of 'doers'
(so as to meet the information needs of 'users') and to provide informatio
n and advice in areas of controversy, with sound direction in areas of gene
ral agreement.
The purpose of this review is three-fold: (i) to outline the process which
lead to the revision of the Canadian Guidelines; (ii) to describe the major
changes made to the second edition of this document; and (iii) to consider
the 'next steps' as they relate to the impact of such guidelines and the m
easurement of outcomes related to economic assessments of pharmaceuticals i
n general.