Economic Evaluation in Global Perspective: A Bibliometric Analysis of the Recent Literature

Abstract

We present a bibliometric analysis of recently published full economic evaluations of health interventions and reflect critically on the implications of our findings for this growing field. We created a database drawing on 14 health, economic, and/or general literature databases for articles published between 1 January 2012 and 3 May 2014 and identified 2844 economic evaluations meeting our criteria. We present findings regarding the sensitivity, specificity, and added value of searches in the different databases. We examine the distribution of publications between countries, regions, and health areas studied and compare the relative volume of research with disease burden. We analyse authors' country and institutional affiliations, journals and journal type, language, and type of economic evaluation conducted. More than 1200 economic evaluations were published annually, of which 4% addressed low-income countries, 4% lower-middle-income countries, 14% upper-middle-income countries, and 83% high-income countries. Across country income levels, 53, 54, 86, and 100% of articles, respectively, included an author based in a country within the income level studied. Biomedical journals published 74% of economic evaluations. The volume of research across health areas correlates more closely with disease burden in high-income than in low-income and middle-income countries. Our findings provide an empirical basis for further study on methods, research prioritization, and capacity development in health economic evaluation.

Keywords: bibliometrics; cost-effectiveness analysis; economic evaluation; high-income countries; low-income countries; middle-income countries.

Figure 1

Number of economic evaluations set in each country. The intensity of shading reflects the number of economic evaluations analyzing each country over the 28‐month period from 1 January 2012 to 3 May 2014

Figure 2

Economic evaluations versus burden of disease by income group. Results are presented in two ways: the lefthand column compares the proportion of the total number of economic evaluations examining each of the 25 health area with the proportion of the total burden of disease accounted for by each health area and the righthand column compares the ranking of the health areas by the volume of economic evaluations and by burden of disease

Figure 3

Proportion of economic evaluations by journal type and income group. The classification of journals by type is provided in Web appendix 6. Articles are disaggregated by the income group(s) of the country or countries studied

Figure 4

Proportion of economic evaluations by analytical type and income group studied. In this figure, ‘cost‐effectiveness analysis’ refers to articles meeting our definition of a full economic evaluation but not containing any keywords to define it more specifically as a cost‐utility or cost‐benefit analysis. Articles can be classified as both cost‐utility and cost‐benefit analyses if they contain keywords for both. Articles are disaggregated by the income group(s) of the country or countries studied. CBA: cost‐benefit analysis, CEA: cost‐effectiveness analysis, CUA: cost‐utility analysis, DALY: disability‐adjusted life‐year, QALY: quality‐adjusted life‐year