An assessment on the methodological differences between economic evaluations on lifestyle anddrug interventions: A systematic review

Introduction An economic evaluation provides information to investigate whether an intervention is a good use of society's resources; it assists policy makers to make an optimal decision for different interventions in various settings. Lifestyle and drug intervention are often implemented for primary preventive purposes in many diseases, among other cardiovascular diseases. Based on the Dutch guideline for cardiovascular risk management, in primary prevention, physical activity and diet as lifestyle intervention and statins as drug intervention are advised for people with low to moderate high CVD risks. Studies have shown favourable outcomes in the cost effectiveness of these two interventions. However, based on the nature of these two interventions, it is interesting to have more insight on how these economic evaluations are conducted and observe if differences exist between studies on lifestyle and drug interventions. The purpose of this systematic review is to assess potential disparities in the methodology between the cost-effectiveness studies on drug treatment (i.e. statins) and lifestyle interventions (i.e. a combination of physical activity and diet advice) for primary prevention of cardiovascular diseases. Further, this study is also interested in potential relationships between different factors (e.g. time horizon, funding source, incremental cost-effectiveness ratios and etc.) and to what extent these associations hold for these two interventions