CHEERS 2022: A Conversation With Jo Mauskopf on Updated Standards for Health Economic Evaluation Reporting

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Guidance Expanded to Reflect Developments in Reporting Economic Evaluations of Health Interventions

As part of the adoption process for new drugs, devices, or medical procedures, healthcare decision-makers must compare health economic evaluations of new products to studies of other available options. Standardized guidelines for reporting enable authors, journal editors, peer-reviewers, and all decision-makers to interpret and compare evaluations more accurately.  

ISPOR has published updated economic evaluation reporting standards, CHEERS 2022, based on the work of their Good Research Practices Task Force. The update includes a new 28-item checklist (available at

Josephine Mauskopf, PhD, Vice of President Health Economics at RTI Health Solutions and member of the ISPOR task force, has kindly agreed to answer a few questions about CHEERS 2022. 

Q: What perspectives did you bring to the Task Force?  
A:  I review a lot of journal articles both as an associate editor and as a peer-reviewer, so I'm very interested in studies being reported fully and transparently so that peer-reviewers and editors can assess their quality.  I am also interested in economic evaluations being presented in ways that make them accessible to non-technical audiences.

Q: What is most important about this new update? 
A: It works to clarify that reporting guidelines are not methods guidelines. 

While researchers have sometimes used CHEERS as a methods guideline, that is not its purpose. Its purpose is to set transparent reporting standards. The updated guidance is careful not to make methods statements or requirements but rather to clarify that authors should report on what methods were used so that reviewers can judge their credibility, validity, and relevance.  

For example, you might create a static model, or you could choose to create an elaborate, dynamic simulation. CHEERS does not say, do one or the other; it says, tell us what you did. If you used assumptions, we want to know what they were and how you determined them. 

Ideally, we want to have the ability to replicate the research using the methods, assumptions, and data you describe and produce the same answer.  

Q: What happens if authors don't use the CHEERS 2022 guidance?  
A: I don't know for sure. I believe that authors will get through the peer-review process more quickly if they have followed the reporting guidelines. Some editors might decide not to send it for review unless the authors have completed the checklist. As an associate editor or peer-reviewer, I always point out limitations if certain things aren't presented.

Q: Do you have any advice regarding the updated standards for companies who outsource their HEOR?  
A: They might want to require completion of the CHEERS checklist along with any study report. It could be requested as a deliverable. 

Q: Is there anything you'd like to say about reporting that we haven't covered?  
A: Yes. You know, not everyone who reads studies that include economic evaluations is a technical expert in such analyses. As processes have evolved to include patients and providers, we need to make it so that they can understand the basic rationale for the design of the evaluation. There's no reason why even a complex economic evaluation can't be made comprehensible. 

I hope that the new CHEERS guidance will result in the reporting of economic evaluations in a way that will help journal editors and technical reviewers determine the quality of submitted studies. Equally important, I hope that they will help authors convey the findings transparently to all groups who might make decisions based on the studies – including patients, providers, and third-party payers. 


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