cost-effectiveness modeling, credibility, imaginary worlds, scientific method, PharmacoEconomics journal


The purpose of this review is to assess whether or not economic evaluation studies published in PharmacoEconomics in 2015 meet the standards of normal science. Two questions are key to the assessment: (i) did the authors attempt to generate testable claims as to the impact of the pharmaceutical product in health care systems and (ii) did the authors suggest how the claims might be evaluated? A total of 31 studies were evaluated, including 14 research articles, 8 systematic reviews and 9 reviews. Although the majority of the studies met recommended standards for cost-effectiveness analysis, none met the standards of normal science. They were best categorized as imaginary worlds or thought experiments. The reader has no idea whether the claims for the products are right or even if they were wrong. Journal editors have two options: (i) require authors to submit cost-effectiveness claims that are evaluable with a protocol suggesting how the claim may be evaluated or (ii) continue to publish non-evaluable cost-effectiveness claims but insist authors indicate that the claims are non-evaluable.

Conflict of Interest