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1.7.4.6 PSA: Uncertainty limits (Yes=1,

No=2, NA=3)

1.7.4.7 PSA: CEAC (Yes=1, No=2, NA=3)

1.7.4.8 PSA: CE Plane (Yes=1, No=2,
NA=3)

1.7.5 Equity analysis: ICER, Financial

Risk Protection (Yes=1, No=2,

NA=3)

1.7.6 Budget impact analysis (Yes=1,
No=2, NA=3)

1.7.7 Stakeholder analysis (Yes=1, No=2,

NA=3)

1.8 Discussion & Conclusion

1.8.1 Result validation Comparison of findings with existing

evidence and explain the possible
reasons for difference in findings

1.8.2 Strength and limitations

1.8.3 Key conclusion and recommendations

Section II: Report/Manuscript Review by Reviewer

S.No. Section heads Description

2.1 Basic information

2.1.1 Appropriateness of the Does the title appropriately justifies the

title (Rate on a scale of 1 to objectives of the study? Specifies the study

10) design, study setting/geography,
intervention/control, disease/program of

concern

2.1.2 Comment on the Rationale, study perspective, time horizon,

completeness of the intervention and comparator, choice of model

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