Health economic reference cases and costing approaches – concepts, international practices and implications for Austria
Strohmaier C, Erdos J
Record ID 32018015607
English
Authors' objectives:
Standardised cost and resource data are crucial for Health Technology Assessment (HTA) and healthcare planning. While many countries have national health economic guidelines, Austria lacks a consensus on a health economic reference case and costing standards.
Authors' results and conclusions:
Costing universally involves identification, measurement, and valuation, with the chosen perspective (e.g., healthcare, societal) being the primary determinant of cost inclusion. The analysis of 12 countries with detailed guidelines reveals a high level of methodological maturity and consensus on core principles like uncertainty analysis. However, significant divergence exists in practice. While bottom-up micro-costing is the gold standard, most countries adopt a pragmatic top-down approach, except the Netherlands which mandates "micro-costing first". Perspective choice creates three clusters: strict healthcare (e.g. Australia), social health insurance (Germany), and comprehensive societal (e.g. the Netherlands). The Netherlands is unique in formally including cross-sectoral costs like education and justice. Valuation is predominantly tied to national tariffs or specific unit costs.
Authors' recommendations:
International guidelines offer a framework of methodological flexibility for Austria. The central decisions involve the politically charged choice of perspective and the definition of relevant costs. This report provides a foundation for developing an Austrian reference case, with next steps including an analysis of national cost data sources to inform a formal guideline development process.
Authors' methods:
This project analysed health economic guidelines, costing manuals, and HTA documents from 59 countries using a multi-stage approach based on ISPOR guidelines and systematic reviews. Data on reference case characteristics and detailed costing processes were extracted and synthesised narratively and in tables.
Details
Project Status:
Completed
Year Published:
2026
URL for published report:
https://eprints.aihta.at/1601/1/HTA-Projektbericht_Nr.174.pdf
URL for additional information:
https://eprints.aihta.at/1601
English language abstract:
An English language summary is available
Publication Type:
Full HTA
Country:
Austria
MeSH Terms
- Cost-Benefit Analysis
- Economics, Medical
- Costs and Cost Analysis
Keywords
- Health economics
- reference case
- costing
- unit cost
- valuation
Contact
Organisation Name:
Austrian Institute for Health Technology Assessment
Contact Address:
Josefstaedter Strasse 39, A-1080 Vienna, Austria
Contact Name:
office@aihta.at
Contact Email:
office@aihta.at
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.