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A review of heath economic evaluation practice in the Netherlands: are we moving forward?

In 2016, the Dutch National Health Care Institute issued new guidelines that aggregated and updated previous recommendations on key elements for conducting economic evaluation. However, the impact on standard practice after the introduction of the guidelines in terms of design, methodology and reporting choices, is still uncertain. To assess this impact, we examine and compare key analysis components of economic evaluations conducted in the Netherlands before (2010-2015) and after (2016-2020) the introduction of the guidelines. We specifically focus on two aspects of the analysis that are crucial in determining the plausibility of the results: statistical methodology and missing data handling. Our review shows how many components of economic evaluations have changed in accordance with the new recommendations towards more transparent and advanced analytic approaches. However, potential limitations are identified in terms of the statistical software and information provided to support the choice of missing data methods.