Incorporating Resource Constraints in Health Economic Evaluations: Overview and Methodological Considerations

Praveen Thokala, Henrique Duarte (), Stuart Wright, Don Husereau, Isabelle Durand-Zaleski, Peter Lindgren, Roelien Postema, Gerardo Machnicki and Louis Garrison
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Praveen Thokala: PT Health Economics Ltd
Henrique Duarte: Putnam Associates
Stuart Wright: University of Manchester
Don Husereau: School of Epidemiology and Public Health at the University of Ottawa
Isabelle Durand-Zaleski: Health Economics and Health Services Research Unit
Peter Lindgren: Swedish Institute for Health Economics
Roelien Postema: Putnam Associates
Gerardo Machnicki: F. Hoffmann-La Roche, Ltd
Louis Garrison: Policy, and Economics (CHOICE) Institute in the School of Pharmacy at the University of Washington

PharmacoEconomics - Open, 2025, vol. 9, issue 2, No 1, 178 pages

Abstract: Abstract It is well known that healthcare resource constraints influence the capacity to deliver care, affecting both the costs and outcomes of medical interventions. If these constraints are not adequately accounted for in economic evaluations, there may be a lack of understanding regarding the full impact of implementing health technologies, leading to decisions being made with suboptimal information. This paper offers an overview of the types of healthcare resource constraints and their potential effects, and introduces a framework grounded in operations research and health economics principles, outlining the methodological considerations for incorporating resource constraints into economic evaluations. Drawing from a literature review and advisory group feedback, three categories of resource constraints were identified: single-use resource constraints, reusable resource constraints and patient throughput constraints. The proposed framework outlines a comprehensive set of steps necessary for effectively incorporating constraints into health economic evaluations and details specific approaches and methodological considerations for each stage to ensure a more accurate and realistic assessment of health interventions. This paper also aims to raise awareness among payers and decision-makers with regards to the limitations of technology evaluations in a resource-constrained health system. Specifically, it suggests that health technology assessment agencies ought to offer guidance on incorporating constraints into the submissions they receive. Moreover, it advocates for a more comprehensive economic evaluation in economic assessments to fully capture an intervention’s value.

Date: 2025
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DOI: 10.1007/s41669-024-00537-z

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