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There are two distinct phases in identifying and quantifying consequences: a broad and systematic review of relevant consequences of the decision being evaluated and identification of data sources and measurement approaches for quantifying them. Cost-effectiveness analyses should identify all significant consequences related to health (survival and/or health status) and resource use in the healthcare sector, as well as consequences in other sectors. Consequences may be distinguished along various dimensions, including the sector in which they occur; groups with different degrees of proximity to the intervention (target population versus other affected groups); and different time points. The Impact Inventory provides a framework for listing all consequences of an intervention, within and outside the healthcare sector, and encouraging explicit discussion of omitted elements and their likely effect on the conclusions of an analysis.

The goal of the reporting chapter is to provide guidance on reporting cost-effectiveness analyses (CEAs) with an emphasis on clarity and transparency. The chapter provides recommendations for each area of a CEA: design, methods and analysis, results, and discussion. It also presents several new areas, such as the need for more clarity in identifying the perspective of the analysis; a structured abstract format; and updated guidance on disclosure of conflicts of interest. Finally, we highlight the importance of reporting intermediate endpoints and disaggregated results, and of providing a detailed presentation of the Impact Inventory to best support the use of CEA in decision making.

The original Panel recommended a societal Reference Case as a point of comparison across studies. The Second Panel reconsidered at length the perspectives that Reference Case analyses should use. Many, if not most published cost-effectiveness analyses (CEAs) have not used a true societal perspective. Further, decision-making bodies that have incorporated CEA into health technology assessment to inform coverage and reimbursement decisions have not adopted a societal perspective. Given this backdrop and various options, the Second Panel recommends that all studies report two Reference Case analyses: one based on a healthcare sector perspective and one based on a societal perspective. We recommend that analysts present all items in an analysis as disaggregated consequences in an Impact Inventory to ensure that all consequences, including those outside the formal healthcare sector, are considered regularly and comprehensively, as they have generally not been to date.