From Evidence to Policy: Economic Evaluations of Healthcare in Malaysia: A Systematic Review

To identify and describe the various economic evaluation studies in Malaysia and to determine the range of incremental cost-effectiveness ratios (ICERs) as reported in these studies. A comprehensive search of the scientific electronic databases was conducted (Medline, EBM Reviews, Embase, and hand search) to identify all published economic evaluation studies related to Malaysian healthcare. Two researchers assessed the quality of selected studies using the Critical Appraisal Skills Programme (CASP) checklist and Quality of Health Economic Studies instrument. The assessment was also reviewed by expert members of the Technical Advisory Committee of Health Technology Economic Evaluations (TACHTEE). A total of 64 full-text articles were assessed for eligibility and included in this systematic review. Thirty studies were partial economic evaluations; the full economic evaluations included 17 cost-effectiveness analyses and 17 cost-utility analyses. From all the reported ICERs, the majority (68%) were categorized as highly cost-effective (ICER of less than 1 gross domestic product (GDP) per capita per quality-adjusted life-years or disability-adjusted life-years gained). This review identifies information gaps and loopholes in health economics research in Malaysia. Additionally, this study provides the information that the majority of published interventions in Malaysia fell within the cost-effectiveness threshold of 1 GDP per capita per quality-adjusted life-years or disability-adjusted life-years gained. •Economic evaluation studies provide valuable inputs in healthcare decision making. Nevertheless, publications related to this area are still sparse in Malaysia; there is a need for more health economics research to cater to the demand.•This review provides essential information in determining the acceptable cost-effectiveness threshold in Malaysia based on a human capital approach or gross domestic product (GDP) per capita, which may influence the value of decision making for health interventions and programs in the country.