title: A Systematic Review of the State of Economic Evaluation for Health Care in India.
abstract: OBJECTIVE
  Economic evaluations are one of the important tools in policy making for rational allocation of resources. Given the very low public investment in the health sector in India, it is critical that resources are used wisely on interventions proven to yield best results. Hence, we undertook this study to assess the extent and quality of evidence for economic evaluation of health-care interventions and programmes in India.
  
  
  METHODS
  A comprehensive search was conducted to search for published full economic evaluations pertaining to India and addressing a health-related intervention or programme. PubMed, Scopus, Embase, ScienceDirect, and York CRD database and websites of important research agencies were identified to search for economic evaluations published from January 1980 to the middle of November 2014. Two researchers independently assessed the quality of the studies based on Drummond and modelling checklist.
  
  
  RESULTS
  Out of a total of 5013 articles enlisted after literature search, a total of 104 met the inclusion criteria for this systematic review. The majority of these papers were cost-effectiveness studies (64%), led by a clinician or public-health professional (77%), using decision analysis-based methods (59%), published in an international journal (80%) and addressing communicable diseases (58%). In addition, 42% were funded by an international funding agency or UN/bilateral aid agency, and 30% focussed on pharmaceuticals. The average quality score of these full economic evaluations was 65.1%. The major limitation was the inability to address uncertainties involved in modelling as only about one-third of the studies assessed modelling structural uncertainties (33%), or ran sub-group analyses to account for heterogeneity (36.5%) or analysed methodological uncertainty (32%).
  
  
  CONCLUSIONS
  The existing literature on economic evaluations in India is inadequate to feed into sound policy making. There is an urgent need to generate awareness within the government of how economic evaluation can inform and benefit policy making, and at the same time build capacity of health-care professionals in understanding the economic principles of health-care delivery system.
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India. shankarprinja@gmail.com.
authors.forename: Shankar
authors.initials: S
authors.lastname: Prinja
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India.
authors.forename: Akashdeep Singh
authors.initials: AS
authors.lastname: Chauhan
authors.affiliation: The George Institute for Global Health, Camperdown, NSW, 2050, Australia.
authors.forename: Blake
authors.initials: B
authors.lastname: Angell
authors.affiliation: Health Policy Research Unit, Institute of Economic Growth, University of Delhi Enclave, Delhi, 110007, India.
authors.forename: Indrani
authors.initials: I
authors.lastname: Gupta
authors.affiliation: The George Institute for Global Health, Camperdown, NSW, 2050, Australia.|Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
mesh_terms: D003362:Cost-Benefit Analysis; D003696:Delivery Rooms / Q000191:economics*; D007194:India