Content of Health Economics Analysis Plans (HEAPs) for trial-based economic evaluations: expert Delphi consensus survey

Objectives. Health Economics Analysis Plans (HEAPs) currently lack consistency, with uncertainty surrounding appropriate content. We aimed to develop a list of essential items that should be included in HEAPs for economic evaluations conducted alongside randomised trials. Methods. A list of potential items for inclusion was developed by examining existing HEAPs. An electronic Delphi survey was conducted among professional health economists. Respondents were asked to rate potential items from 1 (least) to 9 (most) important, suggest additional items, and comment on proposed items (round 1). A second survey (round 2) was emailed to participants, including the participant’s own scores from round 1 along with summary results from the whole panel; participants were asked to re-rate each item. Consensus criteria for inclusion in the final list were predefined as >70% of participants rating an item 7-9 and <15% rating it 1-3 after round 2. A final item selection meeting was held to scrutinise the results and adjudicate on items lacking consensus.Results. 62 participants completed round 1 of the survey. The initial list included 72 potential items; all 72 were carried forward to round 2, and no new items were added. 48 round 1 respondents (77.4%) completed round 2 and reached consensus on 53 items. At the final meeting, the expert panel (n=9) agreed that 58 items should be included in the essential list, moved 9 items to an optional list, and dropped 5 items. Conclusions. Via expert consensus opinion, this study identified 58 items that are considered essential in a HEAP.