Cost-utility analysis (CUA) design checklist

Check applicable HTA or other guidance and set a framework suited to the analysis purpose. Record the basis for choosing utility measures and value sets; explain reasons and impacts if these change.

When to use this worksheet and what completion involves Fictional completed example

EvalCompass Worksheet

Cost-utility analysis (CUA) design checklist

Method: Cost-Utility Analysis

Check applicable HTA or other guidance and set a framework suited to the analysis purpose. Record the basis for choosing utility measures and value sets; explain reasons and impacts if these change.

Basic information

Record the analytical framework.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

Intervention name: product or program: Health support A/B (fictional)
Target disease and population: Formula illustrating generic health states
Comparator: Option A
Analytical perspective: health insurer / societal: Illustration from a provider perspective
Time horizon in years: 1 year
Discount rates for costs and QALYs: Discounting omitted because the formula covers the same fiscal year. Follow the relevant system in an actual analysis.
Applicable HTA guidelines: NICE is a methodological reference. No claim of compliance with Japan's system is made.
Prepared by and date: Staff member A / July 2026 (fictional)

Reason for this entry: These are not actual data for medical decision-making.

Intervention name: product or program

Target disease and population

Comparator

Analytical perspective: health insurer / societal

Time horizon in years

Discount rates for costs and QALYs

Applicable HTA guidelines

Prepared by and date

Writing tips and explanation for this section

About this section

Record the analytical framework.

These are not actual data for medical decision-making.

View the method explanation

Writing tips

Follow each field’s heading to record the program name, focus, period, and other details. Leave undecided matters clearly marked as unresolved.

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Set cost items

Check the cost categories included in the analysis.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

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Cost category	Include or exclude	Data source	Annual amount or estimate	Notes
Support delivery costs	Include	Illustrative assumption	A: JPY 100,000; B: JPY 120,000	Per person. Consider personal payments and other costs in an actual analysis.

Reason for this entry: Match cost units to the population covered by QALYs.

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Cost category	Include or exclude	Data source	Annual amount or estimate	Notes

Writing tips and explanation for this section

About this section

Check the cost categories included in the analysis.

Match cost units to the population covered by QALYs.

View the method explanation

Writing tips

Keep the information in each row aligned. Scroll wide tables horizontally to see every column.

Read the full fictional example

Set utility values

Record utility values and sources for each health state.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

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Health state	Utility value: range depends on the value set and may include negative values	Measure used, such as EQ-5D	Tariff country	Source paper or report
Fictional state A	0.6	Formula illustration; no actual measure used	Not used	Assumed, not a sourced value
Fictional state B	0.7	Formula illustration; no actual measure used	Not used	Assumed, not a sourced value

Reason for this entry: Actual utility ranges depend on the value set and may include negative values. The 0.6 and 0.7 in this example are assumptions illustrating the formula.

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Health state	Utility value: range depends on the value set and may include negative values	Measure used, such as EQ-5D	Tariff country	Source paper or report

Writing tips and explanation for this section

About this section

Record utility values and sources for each health state.

Actual utility ranges depend on the value set and may include negative values. The 0.6 and 0.7 in this example are assumptions illustrating the formula.

View the method explanation

Writing tips

Keep the information in each row aligned. Scroll wide tables horizontally to see every column.

Read the full fictional example

Describe the model structure

Briefly describe the analytical model's structure, such as a Markov model.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

A simple model assuming survival and constant utility over 1 year in each option. It excludes death, state transitions and long-term effects, so do not apply it directly to actual treatment evaluation.

Reason for this entry: State the simplifying model assumptions.

Writing tips and explanation for this section

About this section

Briefly describe the analytical model's structure, such as a Markov model.

State the simplifying model assumptions.

View the method explanation

Writing tips

Use the example as a reference and record what you have established about your own program. Distinguish assumptions and unchecked matters from confirmed facts.

Read the full fictional example

Sensitivity analysis parameters

Record baseline values and alternative sensitivity settings. For probabilistic analysis, justify distributions and parameters.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

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Parameter	Baseline value	Distribution type	Distribution parameters, such as α/β	Evidence
B utility	0.7	No probability distribution set. Compare scenarios.	Recalculate at 0.65 and 0.75.	Illustrative sensitivity settings, not an observed distribution

Reason for this entry: Do not invent distribution parameters without evidence.

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Parameter	Baseline value	Distribution type	Distribution parameters, such as α/β	Evidence

Writing tips and explanation for this section

About this section

Record baseline values and alternative sensitivity settings. For probabilistic analysis, justify distributions and parameters.

Do not invent distribution parameters without evidence.

View the method explanation

Writing tips

Keep the information in each row aligned. Scroll wide tables horizontally to see every column.

Read the full fictional example

Completion check

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

☐ Not checked: The comparator suits the analysis purpose and guidance, and its selection can be explained
☐ Not checked: Aligned utility measures and tariffs with HTA guidelines
☐ Not checked: Examined whether the time horizon captures important differences in costs and health benefits between interventions
☐ Not checked: Aligned cost and QALY discount rates with guidance and purpose, and justified their selection
☐ Not checked: Analyzed uncertainty appropriately and documented whether PSA or CEAC was needed and what was done
☐ Not checked: Considered differences arising from who values health states and how, and the distribution of health benefits

Reason for this entry: This illustrates the formula. Comparators, measures, periods, discounting and uncertainty analysis for an actual system remain unchecked. Actual valuation methods and the distribution of health benefits also remain to be examined.

The comparator suits the analysis purpose and guidance, and its selection can be explained
Aligned utility measures and tariffs with HTA guidelines
Examined whether the time horizon captures important differences in costs and health benefits between interventions
Aligned cost and QALY discount rates with guidance and purpose, and justified their selection
Analyzed uncertainty appropriately and documented whether PSA or CEAC was needed and what was done
Considered differences arising from who values health states and how, and the distribution of health benefits

Writing tips and explanation for this section

About this section

This illustrates the formula. Comparators, measures, periods, discounting and uncertainty analysis for an actual system remain unchecked. Actual valuation methods and the distribution of health benefits also remain to be examined.

View the method explanation

Writing tips

Read each item and check those you have confirmed. Do not use the fictional example’s checkbox states as findings about your own program.

Read the full fictional example

Before writing, check when to use the worksheet and what completion involves

Cost-utility analysis (CUA) design checklist is a worksheet for applying Cost-Utility Analysis in meetings or individual work. For the overall duration of the method, use “Planning example, not a universal standard duration: 3–12 months when utility measurement and a systematic literature review are included” as a reference, adjusting for scale and resources. Fill in what you know provisionally and leave unresolved matters as questions to check next.

When this worksheet is useful

When evaluating cost-effectiveness for listing and pricing new medicines, devices or technologies under an official pricing system (HTA: health technology assessment)
When evaluating interventions with multiple health outcome dimensions, such as longer survival and better quality of life, and combining them into QALYs
When comparing interventions across disease areas using a common measure, QALYs or DALYs, to prioritize budget allocations

Participants and preparation

Health economist leading analysis, clinical specialists reviewing disease natural history and clinical effects, statistician responsible for PSA, and regulatory staff checking HTA guideline compliance.

Bring the materials used for decisions, existing data, and differing stakeholder views to help complete the worksheet.

Suggested order

1. Basic informationRecord the analytical framework.
2. Set cost itemsCheck the cost categories included in the analysis.
3. Set utility valuesRecord utility values and sources for each health state.
4. Describe the model structureBriefly describe the analytical model's structure, such as a Markov model.
5. Sensitivity analysis parametersRecord baseline values and alternative sensitivity settings. For probabilistic analysis, justify distributions and parameters.
6. Completion check

Signs the worksheet is ready for review

Estimated costs and QALYs for intervention and control groups
ICER calculations and cost-effectiveness plane
Probabilistic sensitivity analysis (PSA) results and CEAC

Cautions for review

Underestimating the importance of tariff selection. Applying UK versus Japanese tariffs to identical patient data can substantially change ICER. Always check the tariff required by the receiving regulator.
Check whether the time horizon omits important future costs and benefits. Do not automatically select a lifetime horizon: justify a period capturing differences between interventions and any extrapolation.
Do not make adoption decisions from a single ICER. Analyze uncertainty in values, models and time horizons, and explain methods required by applicable guidance and remaining limitations.

Read a completed fictional example (your entries will not change)

Fictional example; not actual results

A fictional illustrative calculation per person, assuming everyone survives 1 year and utility is constant throughout the year. It does not recommend an actual treatment.

Basic information

Intervention name: product or program: Health support A/B (fictional)
Target disease and population: Formula illustrating generic health states
Comparator: Option A
Analytical perspective: health insurer / societal: Illustration from a provider perspective
Time horizon in years: 1 year
Discount rates for costs and QALYs: Discounting omitted because the formula covers the same fiscal year. Follow the relevant system in an actual analysis.
Applicable HTA guidelines: NICE is a methodological reference. No claim of compliance with Japan's system is made.
Prepared by and date: Staff member A / July 2026 (fictional)

Reason for this entry: These are not actual data for medical decision-making.

Set cost items

Scroll horizontally to view the table

Cost category	Include or exclude	Data source	Annual amount or estimate	Notes
Support delivery costs	Include	Illustrative assumption	A: JPY 100,000; B: JPY 120,000	Per person. Consider personal payments and other costs in an actual analysis.

Reason for this entry: Match cost units to the population covered by QALYs.

Set utility values

Scroll horizontally to view the table

Health state	Utility value: range depends on the value set and may include negative values	Measure used, such as EQ-5D	Tariff country	Source paper or report
Fictional state A	0.6	Formula illustration; no actual measure used	Not used	Assumed, not a sourced value
Fictional state B	0.7	Formula illustration; no actual measure used	Not used	Assumed, not a sourced value

Reason for this entry: Actual utility ranges depend on the value set and may include negative values. The 0.6 and 0.7 in this example are assumptions illustrating the formula.

Describe the model structure

Reason for this entry: State the simplifying model assumptions.

Sensitivity analysis parameters

Scroll horizontally to view the table

Parameter	Baseline value	Distribution type	Distribution parameters, such as α/β	Evidence
B utility	0.7	No probability distribution set. Compare scenarios.	Recalculate at 0.65 and 0.75.	Illustrative sensitivity settings, not an observed distribution

Reason for this entry: Do not invent distribution parameters without evidence.

Completion check

☐ Not checked: The comparator suits the analysis purpose and guidance, and its selection can be explained
☐ Not checked: Aligned utility measures and tariffs with HTA guidelines
☐ Not checked: Examined whether the time horizon captures important differences in costs and health benefits between interventions
☐ Not checked: Aligned cost and QALY discount rates with guidance and purpose, and justified their selection
☐ Not checked: Analyzed uncertainty appropriately and documented whether PSA or CEAC was needed and what was done
☐ Not checked: Considered differences arising from who values health states and how, and the distribution of health benefits

Common errors in judgment

Converting a satisfaction score of 70 to utility 0.7

How to revise: Use validated measures and valuation appropriate to the relevant system.

Reason: Satisfaction scores and health utility are not the same scale.

Assuming a low ICER also means a small budget impact

How to revise: Estimate budget impact separately, including the target population size.

Reason: Cost-effectiveness per unit differs from total expenditure.

Editorial and checking information

Content updated: 2026-09-13Source checked: 2026-09-13 (includes AI cross-checking)No documented human reviewIncludes fictional examplesEditorial policy and scope of checking Cite this page Report a correction

References and checked sections

NICE technology appraisal and highly specialised technologies guidance: Economic evaluation
National Institute for Health and Care Excellence
Section consulted
4.2.14–4.2.16 / 4.3.1–4.3.5
How it relates to the text
QALYs combine time and health-related utility. Compare them with attention to differences in scales and valuation.
Source checked: 2026-09-13 (includes AI cross-checking)
eq5d5l: A command to estimate preference-based values（EuroQol Working Paper Series 19001）
Juan M. Ramos-Goñi／Jesús Oramas-Zarate／Oliver Rivero-Arias · 2019
Section consulted
1 Description, printed p.2
How it relates to the text
Utility value ranges and cautions in the example about the original form's 0–1 notation
Source checked: 2026-09-13 (includes AI cross-checking)

How to cite this page

EvalCompass Editorial Team. “Cost-utility analysis (CUA) design checklist”. EvalCompass, updated 2026-09-13. https://evalcompass.jun-nakatani.com/en/worksheets/cua/

Add the date you accessed the page. Text created by this site is available under CC BY 4.0. Quotations, external materials, and bundled fonts have their own terms of use. When reusing content, credit the source, link to the license, and indicate any changes.

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Change history

2026-09-13 — Checked sources for definitions and applicability conditions, and added fictional examples, reasons for judgments and examples for every worksheet field. Revised unverified claims about history and adoption. Also reviewed existing procedures and cautions, and adjusted fixed participant counts and thresholds and generalizations about institutions. Preserved field positions, types and counts while revising fixed conditions and thresholds in the forms.