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Table 1 Methodological barriers to health economic evidence use in CPG development

From: Health economic evidence in clinical guidelines in South Africa: a mixed-methods study

Thematic areas Sub-themes Solutions
1. Lack of agreed methods and reporting standards • Inconsistent methods / poor standardisation (e.g. clinical end-points or comparators selected)
• Poor reporting of methods
• Methods not agreed by stakeholders in South Africa
• Develop methods and reporting standards informed by broad based stakeholder consultation
2. Lack of available data • Data from South Africa of costs:
- Costs vary by sectors (i.e. public vs. private), settings (e.g. provinces) and levels of care (i.e. primary vs secondary)
- Poor availability of costing data
• Outcomes data to inform decisions
• Strengthen data collection systems
• Develop registries for data collection
• Investment in research
3. Lack of skills to conduct analyses and use economic evidence • Lack of trained health economists, statisticians, mathematicians, team with multi-disciplinary skills
• Lack of skills for CPG developers to read and use HEE
• Train economists and statisticians to work on HEE for CPGs
4. Lack of funding/ insufficient resources • Training and building necessary skills
• Collecting data/evidence to inform economic models (e.g. clinical outcomes, registries)
• Investment in research and training
5. Lack of trust and inability to share • Poor sharing of available data (e.g. private to public) • Develop agreements between groups to share data respectfully