# Health Economic Evaluation Report: [Intervention] for [condition]

> Report template for a health economic evaluation: a comparison of the
> costs and consequences of two or more health interventions, whether
> based on a single study (for example alongside a trial) or on a
> decision-analytic model. The sections follow the 28 items of the
> Consolidated Health Economic Evaluation Reporting Standards 2022
> (CHEERS 2022; Husereau et al., BMJ 2022;376:e067975 and Value Health
> 2022;25(1):3-9); item numbers appear in square brackets, for example
> [10]. Replace every `[bracketed]` value and every row marked *Example*.
> Thresholds, discount rates and reference cases differ by jurisdiction
> and change over time: section 8 lists dated examples to check. This is
> a document format, not financial, medical or reimbursement advice;
> check the current official methods guide of the decision maker and
> involve a qualified health economist.

<!--
Guidance: How to use this template
- CHEERS 2022 applies to every type of economic evaluation (cost-utility,
  cost-effectiveness, cost-benefit, cost-consequence, cost-minimisation)
  and to both trial-based and model-based studies. Delete rows that do
  not apply and say why.
- Write the health economic analysis plan (section 3.1) before outcome
  data are unblinded or the model is populated, and report departures.
- Settle the decision problem first: population, comparators,
  perspective and time horizon (sections 3.2 to 3.5). They determine
  which costs and outcomes count.
- Keep every number consistent: the totals in section 4.2 must match the
  disaggregated costs and the ICER must equal the incremental cost
  divided by the incremental effect.
- Rows marked *Example* describe a fictional cost-utility model by the
  fictional Calderbrook Health Economics Group, comparing nurse-led
  remote monitoring with usual care for adults with chronic heart
  failure, from a fictional national health service perspective in
  pounds sterling. Every number is invented.
-->

## Document control

<!-- Guidance: Treat the report, the analysis plan and the model file as controlled documents with matching version numbers. -->

| Field | Value |
|---|---|
| Document ID | [HEE-ACRONYM-001] |
| Evaluation type | [Cost-utility / Cost-effectiveness / Cost-benefit / Cost-consequence / Cost-minimisation] |
| Study basis | [Trial-based / Model-based / Both] |
| Analysis plan reference | [HEAP version and registration or publication] |
| Model file and version | [File name, software, version, checksum] |
| Decision maker or audience | [Agency, payer, guideline group, journal] |
| Version | [0.1] |
| Status | [Draft / Internal QA / External review / Approved] |
| Owner | [@lead-health-economist] |
| Approvers / reviewers | [@clinical-lead], [@statistician], [@model-validator] |
| Last updated | YYYY-MM-DD |
| Classification | [Confidential / Public] |

### Approvals

| Role | Name | Decision | Date |
|---|---|---|---|
| Lead health economist | [@name] | [Approved] | YYYY-MM-DD |
| Independent model validator | [@name] | [Model checks passed] | YYYY-MM-DD |
| Clinical lead | [@name] | [Clinical assumptions approved] | YYYY-MM-DD |

### Revision history

| Version | Date | Author | Change summary |
|---|---|---|---|
| 0.1 | YYYY-MM-DD | [@name] | First draft of base case |
| 0.2 | YYYY-MM-DD | [@name] | *Example:* Hospitalisation costs updated to the latest national tariff; price year moved to 2025 |
| 1.0 | YYYY-MM-DD | [@name] | Approved after independent model validation |

## Contents

<!-- Guidance: Keep this list in sync with the headings below. -->

1. [Title and abstract](#1-title-and-abstract)
2. [Introduction](#2-introduction)
3. [Methods](#3-methods)
4. [Results](#4-results)
5. [Discussion](#5-discussion)
6. [Other relevant information](#6-other-relevant-information)
7. [Model validation and quality assurance](#7-model-validation-and-quality-assurance)
8. [Jurisdiction reference cases (dated examples)](#8-jurisdiction-reference-cases-dated-examples)
9. [CHEERS 2022 traceability](#9-cheers-2022-traceability)
10. [Glossary and references](#10-glossary-and-references)

## 1. Title and abstract

<!-- Guidance: Name the study as an economic evaluation and identify the interventions compared. The abstract gives context, key methods (including study design and inputs), results (including base case and uncertainty) and alternative analyses. -->

The title and abstract identify the evaluation and summarise it.

### 1.1 Title [1]

[Type of economic evaluation] of [intervention] versus [comparator]
for [population] in [setting or country]

### 1.2 Abstract [2]

| Heading | Content |
|---|---|
| Context and objective | [Decision problem in one or two sentences] |
| Methods | [Evaluation type, perspective, time horizon, model or trial, discount rate, price year] |
| Results | *Example:* Remote monitoring cost £2,360 more per patient and gained 0.094 QALYs over a lifetime horizon, an incremental cost-effectiveness ratio of £25,106 per QALY gained. The probability of being cost-effective was 0.49 at £25,000 and 0.66 at £35,000 per QALY. |
| Alternative analyses | [Key scenario and subgroup results] |
| Conclusions | [Interpretation with reference to the decision threshold and uncertainty] |

## 2. Introduction

<!-- Guidance: Give the context for the decision, the specific question and why an economic evaluation is needed now. Name the decision maker the analysis is designed to inform. -->

This section states the decision problem [3].

| Item | Content |
|---|---|
| Background | [Burden of the condition, current practice, the new intervention] |
| Decision problem | *Example:* Should a national health service fund nurse-led remote monitoring for adults discharged after a heart failure admission? |
| Policy relevance | [Who decides, when, and what they need] |
| Study question | [Cost-effectiveness of X versus Y in population P, from perspective Q, over horizon T] |
| Previous economic evidence | [Summary of existing evaluations and why a new one is needed] |

## 3. Methods

<!-- Guidance: Describe every analytic choice and its justification. Most reviewer queries concern choices left implicit: perspective, horizon, discounting, price year and model structure. -->

This section reports the design of the evaluation, items [4] to [21].

### 3.1 Health economic analysis plan [4]

| Item | Detail |
|---|---|
| Plan exists? | [Yes / No] |
| Where available | [Registry, repository or publication] |
| Date finalised | YYYY-MM-DD, [before or after outcome data were available] |
| Departures from the plan | [List with reasons, or "none"] |

### 3.2 Study population [5]

| Item | Detail |
|---|---|
| Population | *Example:* Adults aged 50 and over discharged after a first hospital admission for heart failure with reduced ejection fraction |
| Baseline characteristics used in the model | [Mean age, sex mix, severity] |
| Subgroups | [Pre-specified subgroups and why they matter] |
| Source | [Trial, cohort or registry used to describe the population] |

### 3.3 Setting and location [6]

[Country, health system, care setting and other context that may affect
costs, care pathways and outcomes.]

### 3.4 Comparators [7]

| ID | Comparator | Description | Why chosen |
|---|---|---|---|
| CMP-01 | *Example:* Nurse-led remote monitoring | Daily weight and symptom reports via a tablet, reviewed by a specialist nurse, 12 months | New intervention |
| CMP-02 | *Example:* Usual care | Routine follow-up by primary care and a cardiology clinic | Current standard in the setting |
| CMP-03 | [Other relevant option] | [Description] | [Include or justify exclusion] |

### 3.5 Perspective, time horizon and discounting [8, 9, 10]

| Item | Choice | Justification |
|---|---|---|
| Perspective [8] | *Example:* Health service and personal social services | Matches the decision maker's reference case |
| Costs included | [Categories within the perspective] | [Reason] |
| Time horizon [9] | *Example:* Lifetime (to age 100) | Heart failure affects survival, so effects extend beyond the trial |
| Cycle length (models) | [3 months] | [Matches the timing of events] |
| Discount rate [10] | *Example:* 3.5% per year for costs and outcomes | [Reference case; scenario at 1.5% for outcomes] |

Costs and outcomes in year $t$ are discounted to present value with
rate $r$:

$$
PV = \sum_{t=0}^{T} \frac{X_t}{(1+r)^{t}}
$$

*Example:* A cost of £1,000 in each of years 0 to 4, discounted at 3.5%,
has a present value of £4,673.08.

| Year | Discount factor at 3.5% | Present value of £1,000 |
|---|---|---|
| 0 | 1.0000 | £1,000.00 |
| 1 | 0.9662 | £966.18 |
| 2 | 0.9335 | £933.51 |
| 3 | 0.9019 | £901.94 |
| 4 | 0.8714 | £871.44 |
| Total | | £4,673.08 |

### 3.6 Outcomes: selection, measurement and valuation [11, 12, 13]

| Item | Detail |
|---|---|
| Outcome measure selected [11] | *Example:* Quality-adjusted life years (QALYs); secondary: hospital admissions avoided, life years |
| Why this measure | [Decision maker's reference case; captures length and quality of life] |
| Measurement [12] | [Instrument, for example a generic preference-based questionnaire, administered at stated time points in the trial] |
| Valuation [13] | [Value set or tariff, its country and year, population whose preferences were used] |
| Adjustments | [Age-related utility decrements, disutilities for events] |

### 3.7 Measurement and valuation of resources and costs [14]

| Resource | Quantity source | Unit cost source | Unit cost (*Example*) |
|---|---|---|---|
| Remote monitoring kit and platform | Supplier quote | Supplier price | £620 per patient-year |
| Specialist nurse time | Trial time log | National pay scales with on-costs | £58 per hour |
| Heart failure hospital admission | Trial and registry | National tariff | £3,950 per admission |
| Primary care consultation | Trial diaries | National unit costs | £42 per visit |
| [Resource] | [Source] | [Source] | [Value] |

### 3.8 Currency, price date and conversion [15]

| Item | Detail |
|---|---|
| Currency | *Example:* Pounds sterling (GBP) |
| Price year | *Example:* 2025 |
| Inflation index | [Index name and source] |
| Currency conversion | [Purchasing power parity rate, source and year, if costs from other countries were used] |

### 3.9 Rationale and description of the model [16]

[Describe the model type, structure, health states or pathways and why
this structure suits the decision problem. Make the model available or
explain how to access it.]

*Example:* A Markov cohort model with three health states and a 3-month
cycle. Patients start in "Stable heart failure"; each cycle they may be
admitted to hospital, which raises the risk of death, or die. Remote
monitoring is assumed to reduce the rate of admission.

```mermaid
flowchart LR
    S["Stable heart failure"] -->|"admission"| H["Post-admission"]
    H -->|"recovery after 1 cycle"| S
    S -->|"death"| D["Dead"]
    H -->|"death (higher risk)"| D
    S -->|"stay"| S
```

### 3.10 Analytics and assumptions [17]

| ID | Assumption or method | Justification | Tested in |
|---|---|---|---|
| ASM-01 *(Example)* | Remote monitoring reduces admissions by a constant relative rate for 12 months, then the effect stops | Duration of service; no evidence of lasting effect | Scenario SC-02 (effect lasts 3 years) |
| ASM-02 | [Extrapolation of survival beyond trial follow-up, model chosen] | [Fit statistics, clinical plausibility] | [Scenario] |
| ASM-03 | [Handling of missing cost or utility data] | [Method, for example multiple imputation] | [Scenario] |
| ASM-04 | Half-cycle correction | [Method] | Not applicable |

### 3.11 Characterising heterogeneity [18]

[Describe methods for estimating how results vary between subgroups
defined by baseline characteristics, for example age or disease
severity, and say which subgroups were pre-specified.]

### 3.12 Characterising distributional effects [19]

[Describe how impacts are distributed across groups that are relevant
for equity, for example by socioeconomic status or region, and any
method used, such as distributional cost-effectiveness analysis or
equity weights. If not done, say so and why.]

### 3.13 Characterising uncertainty [20]

| Type | Method |
|---|---|
| Parameter uncertainty | *Example:* Probabilistic sensitivity analysis, 5,000 Monte Carlo draws; beta distributions for probabilities and utilities, gamma for costs, log-normal for relative effects |
| Deterministic sensitivity | One-way analyses on each key parameter across its 95% CI or a plausible range |
| Structural uncertainty | Scenarios on model structure and assumptions (ASM IDs) |
| Methodological uncertainty | Scenarios on discount rate and perspective |
| Value of information | [Expected value of perfect information, if done] |

### 3.14 Approach to engagement with patients and others [21]

[Describe how patients, carers, the public, clinicians or payers were
involved in the design, for example in choosing outcomes or reviewing
assumptions. If no engagement took place, state that.]

## 4. Results

<!-- Guidance: Report all input values, then the base case with disaggregated costs and outcomes, then uncertainty. Show incremental results against the next best option when there are more than two comparators. -->

This section reports items [22] to [25].

### 4.1 Study parameters [22]

| ID | Parameter | Base case | Distribution | Source |
|---|---|---|---|---|
| PAR-01 | *Example:* Quarterly probability of admission, usual care | 0.080 | Beta | Fictional registry |
| PAR-02 | Rate ratio for admission, remote monitoring | 0.80 | Log-normal | Fictional trial |
| PAR-03 | Utility, stable heart failure | 0.72 | Beta | Trial questionnaire data |
| PAR-04 | Disutility of an admission | 0.10 for one cycle | Beta | Literature |
| PAR-05 | Cost per admission | £3,950 | Gamma | National tariff |
| PAR-06 | [Parameter] | [Value] | [Distribution] | [Source] |

### 4.2 Summary of main results [23]

Disaggregated mean costs per patient, discounted (*Example*):

| Cost category | Remote monitoring | Usual care | Difference |
|---|---|---|---|
| Intervention delivery | £2,150 | £0 | £2,150 |
| Hospital admissions | £8,940 | £9,980 | -£1,040 |
| Primary care | £2,310 | £2,060 | £250 |
| Medicines | £1,420 | £420 | £1,000 |
| Total | £14,820 | £12,460 | £2,360 |

Base-case cost-effectiveness (*Example*):

| Comparator | Total cost | Total QALYs | Incremental cost | Incremental QALYs | ICER (£ per QALY) |
|---|---|---|---|---|---|
| Usual care | £12,460 | 4.118 | | | |
| Remote monitoring | £14,820 | 4.212 | £2,360 | 0.094 | 25,106 |

The incremental cost-effectiveness ratio (ICER) and the net monetary
benefit (NMB) at a threshold $\lambda$ per QALY are:

$$
\text{ICER} = \frac{\Delta C}{\Delta E}, \qquad \text{NMB} = \lambda\,\Delta E - \Delta C
$$

*Example:* 2,360 / 0.094 = 25,106. Net monetary benefit is positive
when the ICER is below the threshold:

| Threshold (£ per QALY) | Incremental NMB |
|---|---|
| 20,000 | -£480 |
| 25,000 | -£10 |
| 30,000 | £460 |
| 35,000 | £930 |

### 4.3 Effect of uncertainty [24]

Deterministic one-way sensitivity analysis (*Example*):

| Parameter varied | Low value | ICER at low | High value | ICER at high |
|---|---|---|---|---|
| Intervention delivery cost | £1,720 (-20%) | £20,532 | £2,580 (+20%) | £29,681 |
| [Rate ratio for admission] | [0.70] | [value] | [0.90] | [value] |
| [Utility, stable] | [value] | [value] | [value] | [value] |

The intervention cost row changes only the intervention delivery cost,
so the incremental cost moves by £430 either way (£1,930 and £2,790)
while incremental QALYs stay 0.094.

Probabilistic sensitivity analysis (*Example*):

| Threshold (£ per QALY) | Probability remote monitoring is cost-effective |
|---|---|
| 20,000 | 0.38 |
| 25,000 | 0.49 |
| 30,000 | 0.58 |
| 35,000 | 0.66 |

Present the cost-effectiveness plane (scatter of incremental cost
against incremental QALYs for every draw) and the cost-effectiveness
acceptability curve as figures, and report scenario results:

| ID | Scenario | ICER (£ per QALY) |
|---|---|---|
| SC-01 | Discount rate for outcomes 1.5% | [value] |
| SC-02 | Effect of monitoring lasts 3 years (ASM-01) | [value] |
| SC-03 | Societal perspective including carer time | [value] |

### 4.4 Effect of engagement with patients and others [25]

[Report any difference that engagement made to the approach or the
findings, for example an outcome added at the request of a patient
panel. If there was no engagement, state that.]

## 5. Discussion

<!-- Guidance: Summarise findings, limitations, ethical or equity considerations and generalisability, and how the results fit with existing knowledge. Do not hide a high-uncertainty result behind a favourable point estimate. -->

This section covers item [26].

### 5.1 Key findings

[Summarise the base case and the main uncertainty in plain language.]

*Example:* The point estimate of £25,106 per QALY lies inside a
threshold range of £25,000 to £35,000, but the probability of cost
effectiveness at the lower end of that range is about one half, so the
decision is sensitive to the threshold chosen and to the cost of the
service.

### 5.2 Limitations

- [Evidence gaps, for example a short trial follow-up extrapolated to a
  lifetime]
- [Structural assumptions with large effects on the ICER]
- [Costs or outcomes outside the perspective that may matter]

### 5.3 Generalisability and current knowledge

[Discuss how the results transfer to other settings, how they compare
with previous evaluations and what new evidence would most reduce
decision uncertainty.]

### 5.4 Equity and ethical considerations

[Summarise the distributional findings from section 3.12 and any
ethical issues for the decision maker.]

## 6. Other relevant information

<!-- Guidance: CHEERS asks for funding, the role of funders and conflicts of interest. Fill both even when the answer is "none". -->

This section covers items [27] and [28].

| Item | Detail |
|---|---|
| Source of funding [27] | [Funder, grant number, role in identification, design, conduct and reporting] |
| Conflicts of interest [28] | [Each author's interests, following the journal or ICMJE disclosure form] |
| Model and data availability | [Repository, licence, conditions] |

## 7. Model validation and quality assurance

<!-- Guidance: Not a CHEERS item, but reviewers and decision makers expect evidence that the model works. Record each check, who did it and the result. -->

Record the checks performed on the model and the analysis.

| ID | Check | Method | Done by | Result |
|---|---|---|---|---|
| QA-01 | Face validity | Clinical experts review structure and assumptions | [@name] | [Pass / issues] |
| QA-02 | Technical verification | Extreme value tests, cohort traces sum to 1, double programming of key formulas | [@model-validator] | [Pass] |
| QA-03 | Internal validity | Model reproduces trial results it was fitted to | [@name] | [Pass] |
| QA-04 | External validity | Model predictions compared with independent data | [@name] | [Pass] |
| QA-05 | Cross-validity | Results compared with other published models | [@name] | [Pass] |

## 8. Jurisdiction reference cases (dated examples)

<!-- Guidance: Decision makers set their own methods. Name the one you target, cite its current guide and report deviations from its reference case. The rows below are examples checked on the date shown, not recommendations. -->

Methods guides and thresholds change. Check the current official page
before relying on any figure below.

| Jurisdiction | Methods guide | Points to check | Status checked |
|---|---|---|---|
| England (example) | NICE health technology evaluations manual (PMG36), https://www.nice.org.uk/process/pmg36 | Perspective, discount rate, outcome measure, threshold. NICE moved its standard threshold range from £20,000 to £30,000 per QALY to £25,000 to £35,000 per QALY from April 2026, as reported by the Office of Health Economics on 2026-02-25; confirm on the current NICE manual | October 2026; NICE pages blocked automated access, figure confirmed through OHE, 2026-02-25 |
| United States (example) | Second Panel on Cost-Effectiveness in Health and Medicine (Sanders et al., JAMA 2016;316(10):1093-1103) | Healthcare sector and societal reference cases, impact inventory, discount rate | October 2026 |
| European Union (example) | Regulation (EU) 2021/2282 on health technology assessment: joint clinical assessments address clinical aspects, while economic evaluation and pricing remain national decisions | Which national agency and guide applies; check the Commission HTA pages | October 2026; official pages blocked automated access, check the current text |
| [Your jurisdiction] | [Guide and URL] | [Items] | YYYY-MM-DD |

## 9. CHEERS 2022 traceability

<!-- Guidance: Use this table to fill the official CHEERS 2022 checklist, giving the section here and the page in the submitted report. -->

| Item | Topic (short) | Section in this file | Page |
|---|---|---|---|
| 1 | Title | 1.1 | [p] |
| 2 | Abstract | 1.2 | [p] |
| 3 | Background and objectives | 2 | [p] |
| 4 | Health economic analysis plan | 3.1 | [p] |
| 5 | Study population | 3.2 | [p] |
| 6 | Setting and location | 3.3 | [p] |
| 7 | Comparators | 3.4 | [p] |
| 8 | Perspective | 3.5 | [p] |
| 9 | Time horizon | 3.5 | [p] |
| 10 | Discount rate | 3.5 | [p] |
| 11 | Selection of outcomes | 3.6 | [p] |
| 12 | Measurement of outcomes | 3.6 | [p] |
| 13 | Valuation of outcomes | 3.6 | [p] |
| 14 | Measurement and valuation of resources and costs | 3.7 | [p] |
| 15 | Currency, price date and conversion | 3.8 | [p] |
| 16 | Rationale and description of model | 3.9 | [p] |
| 17 | Analytics and assumptions | 3.10 | [p] |
| 18 | Characterising heterogeneity | 3.11 | [p] |
| 19 | Characterising distributional effects | 3.12 | [p] |
| 20 | Characterising uncertainty | 3.13 | [p] |
| 21 | Approach to engagement with patients and others | 3.14 | [p] |
| 22 | Study parameters | 4.1 | [p] |
| 23 | Summary of main results | 4.2 | [p] |
| 24 | Effect of uncertainty | 4.3 | [p] |
| 25 | Effect of engagement with patients and others | 4.4 | [p] |
| 26 | Study findings, limitations, generalisability and current knowledge | 5 | [p] |
| 27 | Source of funding | 6 | [p] |
| 28 | Conflicts of interest | 6 | [p] |

## 10. Glossary and references

<!-- Guidance: Define the terms non-economists on the team or committee will meet in the report. -->

### 10.1 Glossary

| Term | Meaning in this template |
|---|---|
| QALY | Quality-adjusted life year: a year of life weighted by a utility between 0 (dead) and 1 (full health) |
| ICER | Incremental cost-effectiveness ratio: extra cost divided by extra health effect |
| NMB | Net monetary benefit: health gain valued at the threshold minus the extra cost |
| Threshold | The value per unit of health gain the decision maker uses to judge cost effectiveness |
| Perspective | Whose costs and outcomes are counted (health service, payer, society) |
| PSA | Probabilistic sensitivity analysis: repeated model runs with inputs drawn from their distributions |
| CEAC | Cost-effectiveness acceptability curve: probability of cost effectiveness across thresholds |
| HEAP | Health economic analysis plan |

### 10.2 Methodological references

- Husereau D, Drummond M, Augustovski F, de Bekker-Grob E, et al.
  Consolidated Health Economic Evaluation Reporting Standards 2022
  (CHEERS 2022) statement: updated reporting guidance for health
  economic evaluations. BMJ. 2022;376:e067975.
  https://doi.org/10.1136/bmj-2021-067975 (also Value Health.
  2022;25(1):3-9, https://doi.org/10.1016/j.jval.2021.11.1351)
- Elvidge J, Hawksworth C, Avşar TS, Zemplenyi A, et al. Consolidated
  Health Economic Evaluation Reporting Standards for interventions that
  use artificial intelligence (CHEERS-AI). Value Health.
  2024;27(9):1196-1205. https://doi.org/10.1016/j.jval.2024.05.006
- Sanders GD, Neumann PJ, Basu A, Brock DW, et al. Recommendations for
  conduct, methodological practices, and reporting of cost-effectiveness
  analyses: Second Panel on Cost-Effectiveness in Health and Medicine.
  JAMA. 2016;316(10):1093-1103. https://doi.org/10.1001/jama.2016.12195

For interventions that use artificial intelligence, also report the
CHEERS-AI items. Related templates in this library:
`science/clinical-trial-report` (the trial behind a trial-based
evaluation), `science/trial-protocol` (planning the trial and its
economic outcomes), `academic/stats-analysis-plan` (analysis plan
structure) and `academic/stats-confidence-intervals` (precision of
estimates).

## Standard and licence note

Structure aligned with the CHEERS 2022 statement (Husereau et al., BMJ
2022;376:e067975 and Value Health 2022;25(1):3-9; 28 items), published
open access and listed by the EQUATOR Network. This template follows
the CHEERS 2022 item numbering with short topic names and original
wording; it reproduces no checklist or explanation text. Official
checklist: CHEERS Task Force via the EQUATOR Network,
https://www.equator-network.org/reporting-guidelines/cheers/. Checked in
October 2026; check the current version, any extension that applies
and the current methods guide of your decision maker before use. This
is a document format, not financial, medical or reimbursement advice;
consult a qualified health economist. Template licence: MIT.