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What are the difficulties in conducting health economic evaluations in low- and middle- income countries?

Researchers working in low- and middle- income countries (LMICs) face a range of challenges in conducting economic evaluations. These may be technical or context-specific in nature. Technical difficulties are defined as those that are directly related to the methodology used in conducting an economic evaluation and can be overcome by learning about the tools and techniques available to address these issues. Context-specific difficulties, on the other hand, refer to the difficulties that indirectly affect the study, varying by country or setting, and often outside the control of the study. These include, for example, political economy, lack of understanding (or misunderstanding) of economic evaluation results. The following are difficulties in conducting economic evaluation obtained from the survey conducted by the Health Intervention and Technology Assessment Program (HITAP): View our Method & Process

Technical (methodological) difficulties

  1. There is a lack of robust local clinical data
  2. Poor reporting on economic evaluations
  3. There is a lack of data on costing
  4. There is a paucity of commonly accepted guidelines for economic evaluations in LMICs
  5. There is a lack of local data for estimating QALYs or DALYs (in cost-utility analysis)
  6. It is difficult to interpret and use the results of the cost effectiveness analysis (CEA)

Context specific difficulties

  1. Economic evaluations are not formally linked to the healthcare decision-making process
  2. There is limited local research capacity
  3. There is a lack of funding for the necessary research
  4. Misunderstandings and communications weakness between researchers, academia and end users of the evidence
  5. There are limited number of published local journals with a standard review process