Economic evaluations of health interventions focus on comparative analysis of alternative approaches concerning their costs and outcomes. These help healthcare decision-makers to take informed decisions about appropriate resource allocation for healthcare, such as the approval of new drugs, devices, or procedures. However, economic evaluations often face reporting challenges because of the enormous amount of information to analyze study findings further.[1]

Realising this gap, the ISPOR set up a task force that came up with the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) statement [2] in 2013, with an intention to optimize reporting of health economic evaluations. The purpose of this statement was to guide authors with accurate reporting of the types, methodologies, and the context of the comparison between health interventions to help readers and reviewers while interpreting the study. This first edition was updated thoroughly and the revised CHEERS 2022 statement [3] was published in January 2022, replacing the previous reporting guide. The latest guidance document intends to make it more applicable to all types of health economic evaluations, advances in the field, and the increasing stakeholder involvement that includes patients and the public. The primary aims of the CHEERS 2022 statement include helping both the (a) researchers reporting economic evaluations for peer-reviewed journals as well as the (b) peer reviewers and editors for assessment of these evaluations for publication. Moreover, the statement is mostly applicable to any form of intervention aimed at enhancing the health of individuals or the population, irrespective of the context (such as healthcare, public health, education, social care, etc.).[3]

Several developments have motivated an update since the first CHEERS statement (2013).[2] These developments include feedback on a few limitations of the statement, such as the lack of reporting guidance for cost-benefit analyses.[4] The document has been misused, such as to assess the quality of methods, despite the availability of other tools,[5] instead of the quality of reporting.[6] The document has also been used for quantitative scoring of studies in systematic reviews, which it is not designed for and which may mislead readers and reviewers.[3, 7]

The updated, i.e., the CHEERS 2022, statement comprises a checklist with 28-items, including four substantially new items: (1) a plan for health economics analysis, (2) a characterization of distributional effects, (3) a method for patient engagement while also involving those affected by the study, and (4) the impact this engagement. Checklist items are further divided into seven major categories, including title, abstract, introduction, methods, results, discussion, and other relevant information. The statement also includes an Explanation and Elaboration report with supplementary user tools and guidance,[8] which should be referred to first before the checklist items to ensure the correct interpretation of the description of each item.[3]

The statement is not meant to be used as a scoring tool or an assessment tool for the appropriateness of methods. Neither is it intended for reporting budget impact analyses and constrained optimization studies. Developers of this statement expect that understanding the reporting requirements will aid analysts for planning studies, as well as various health technology assessment (HTA) bodies for guidance on reporting due to an increasing need for transparent decision-making.[3]

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  1. ISPOR News: CHEERS 2022: Global Expert Panel Publishes Updated Consolidated Health Economic Evaluation Reporting Standards. January 2022. Available at:
  2. Husereau D, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. BMJ 2013; 346:f1049.
  3. Husereau D, et al. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) Statement: Updated Reporting Guidance for Health Economic Evaluations. Value Health 2022; 25(1):3-9.
  4. Sanghera S, et al. Adapting the CHEERS Statement for reporting cost-benefit analysis. Pharmacoeconomics 2015; 33:533-534.
  5. Walker DG, et al. Best practices for conducting economic evaluations in health care: a systematic review of quality assessment tools. Agency for Healthcare Research and Quality; 2012. Available at:
  6. Caulley L, et al. Reporting guidelines of health research studies are frequently used inappropriately. J Clin Epidemiol 2020; 122:87-94.
  7. Jüni P, et al. The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 1999; 282:1054-1060.
  8. Husereau D, et al. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) Explanation and Elaboration: A report of the ISPOR CHEERS II Good Practices Task Force. Value Health 2022; 25(1):10-31.

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