Risk of Bias in Trial-based Economic Evaluations

  • S.M.A.A. Evers
  • C.C. Adarkwah


Objective: The objective of this article is to give first an overview of the risks of bias in trial-based economic evaluations, and second to identify how key sources for bias can be revealed and overcome (bias-reducing strategies) in future trial-based economic evaluation in the field of health psychology. Design: Narrative reviews discussing a particular source of bias in trial-based economic evaluation and bias-reducing strategies. Results: The different forms of bias are presented, and assigned to a particular trial phase. A distinction is made between pre-trial biases, biases during the trial and biases that are relevant after the actual trial. All potential forms of bias are discussed in detail and strategies are shown to detect and overcome these biases. Conclusion: In order to avoid bias in trial-based economic evaluations, one has to be aware of all of the possible forms of bias and all stakeholders have to examine trial-based economic evaluations in a rigorous and stringent manner. This article can be helpful in this examination as it gives an overview of the possible biases which researchers should take into account.