Points to consider for incorporating climate impacts into health economic evaluation

OBJECTIVES: Methodological approaches for incorporating the external effects resulting from climate impacts into health economic evaluation (HEE) are a vivid field of research. Combining established standards for reporting HEE and climate footprints (CF), our aim is to develop a structured list of points to consider for reporting full HEE that combines the two methodologies, referred to as climate-extended HEE METHODS: We mapped a transparency catalogue with methodological items for estimating CF to the reporting items described in the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). We identified synergies and developed a proposal of methodological points to report for climate-extended HEE, structured by the CHEERS items. The proposal was validated using three published climate-extended HEEs and a hypothetical case study.. RESULTS: We proposed extensions to 18 reporting items of CHEERS, for example, adding more detail to the measurement and valuation of resources and costs to facilitate a process- or cost-based estimation of CF. Using three identified publications and a hypothetical case study, examples on how all items could be addressed are provided, including a presentation of climate-extended versions of the standard summary measures of HEE. CONCLUSIONS: The proposed catalogue can be used for reporting and reviewing climate-extended HEEs. Further work is necessary to include planetary boundaries beyond climate change. Future steps could be, first, to develop a reporting standard within a formal Delphi process of all relevant stakeholders. Second, the catalogue can be used to develop standards of analytic choices for specific decision makers or problems.