PCN42 THE HEALTH UTILITY BOOK (HUB): TOWARD A CENTRALIZED, SYSTEMATIC APPROACH TO THE IDENTIFICATION, APPRAISAL, AND USE OF HEALTH STATE UTILITY VALUES FOR REIMBURSEMENT DECISION MAKING

Cost-utility analysis (CUA) is a widely recommended form of health economic evaluation worldwide. The outcome measure in CUA is quality-adjusted life-years (QALYs), which are calculated using health state utility values (HSUVs) and corresponding life-years. Therefore, HSUVs play a significant role in determining cost-effectiveness. Formal adoption and endorsement of CUAs by reimbursement authorities motivates methodological advancement in HSUV measurement and application. A large body of evidence exploring various methods in measuring HSUVs has accumulated, imposing challenges for investigators in identifying and applying HSUVs to CUAs. First, large variations in HSUVs between studies are often reported, and these may lead to different cost-effectiveness conclusions. Second, issues concerning the quality of studies that generate HSUVs are increasingly highlighted in the literature. This issue is compounded by the limited published guidance and methodological standards for assessing the quality of these studies. Third, reimbursement decision making is a context-specific process. Therefore, while an HSUV study may be of high quality, it is not necessarily appropriate for use in all reimbursement jurisdictions. To address these issues, by promoting a systematic approach to study identification, critical appraisal, and appropriate use, we are developing the Health Utility Book (HUB). The HUB consists of an HSUV registry, a quality assessment tool for health utility studies, and a checklist for interpreting their use in CUAs. We anticipate that the HUB will make a timely and important contribution to the rigorous conduct and proper use of health utility studies for reimbursement decision making. In this way, health care resource allocation informed by HSUVs may reflect the preferences of the public, improve health outcomes of patients, and maintain the efficiency of health care systems.

Download Full-text

The impact of multiple sclerosis severity on health state utility values: Evidence from Australia

Multiple Sclerosis Journal ◽

10.1177/1352458516672014 ◽

2016 ◽

Vol 23 (8) ◽

pp. 1157-1166 ◽

Cited By ~ 13

Author(s):

Hasnat Ahmad ◽

Bruce V Taylor ◽

Ingrid van der Mei ◽

Sam Colman ◽

Beth A O’Leary ◽

...

Keyword(s):

Multiple Sclerosis ◽

Disease Severity ◽

Severe Disease ◽

Health Utility ◽

Health State Utility ◽

Health State ◽

Utility Values ◽

Health State Utility Values ◽

Economic Analyses ◽

The Impact

Background: The measurement of health state utility values (HSUVs) for a representative sample of Australian people with multiple sclerosis (MS) has not previously been performed. Objectives: Our main aim was to quantify the HSUVs for different levels of disease severities in Australian people with MS. Method: HSUVs were calculated by employing a ‘judgement-based’ method that essentially creates EQ-5D-3L profiles based on WHOQOL-100 responses and then applying utility weights to each level in each dimension. A stepwise linear regression was used to evaluate the relationship between HSUVs and disease severity, classified as mild (Expanded Disability Status Scale (EDSS) levels: 0–3.5), moderate (EDSS levels: 4–6) and severe (EDSS levels: 6.5–9.5). Results: Mean HSUV for all people with MS was 0.53 (95% confidence interval (CI): 0.52–0.54). Utility decreased with increasing disease severity: 0.61 (95% CI: 0.60–0.62), 0.51 (95% CI: 0.50–0.52) and 0.40 (95% CI: 0.38–0.43) for mild, moderate and severe disease, respectively. Adjusted differences in mean HSUV between the three severity groups were statistically significant. Conclusion: For the first time in Australia, we have quantified the impact of increasing severity of MS on health utility of people with MS. The HSUVs we have generated will be useful in further health economic analyses of interventions that slow progression of MS.

Download Full-text

PCN41 THE HEALTH UTILITY BOOK (HUB): A REGISTRY OF HEALTH STATE UTILITY VALUES IN ONCOLOGY

Value in Health ◽

10.1016/j.jval.2019.04.165 ◽

2019 ◽

Vol 22 ◽

pp. S63

Author(s):

M. Zoratti ◽

T. Zhou ◽

K. Chan ◽

O. Levine ◽

M. Krahn ◽

...

Keyword(s):

Health Utility ◽

Health State Utility ◽

Health State ◽

Utility Values ◽

Health State Utility Values

Download Full-text

Health Utility Book (HUB)–Cancer: Protocol for a Systematic Literature Review of Health State Utility Values in Cancer

MDM Policy & Practice ◽

10.1177/2381468319852594 ◽

2019 ◽

Vol 4 (2) ◽

pp. 238146831985259

Author(s):

Michael James Zoratti ◽

Ting Zhou ◽

Kelvin Chan ◽

Oren Levine ◽

Murray Krahn ◽

...

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Health Utility ◽

Cost Utility ◽

Health State Utility ◽

Health State ◽

Cancer Treatments ◽

Utility Values ◽

Life Years ◽

Health State Utility Values

Background. Treatment options in oncology are rapidly advancing, and public payer systems are increasingly under pressure to adopt new but expensive cancer treatments. Cost-utility analyses (CUAs) are used to estimate the relative costs and effects of competing interventions, where health outcomes are measured using quality-adjusted life years (QALYs). Health state utility values (HSUVs) are used to reflect health-related quality of life or health status in the calculation of QALYs. To support reimbursement agencies in the appraisal of oncology drug submissions, which typically include a CUA component, we have proposed a systematic literature review of published HSUV estimates in the field of oncology. Methods. The following databases will be searched: MEDLINE, EMBASE, EconLit, and CINAHL. A team of reviewers, working independently and in duplicate, will evaluate abstracts and full-text publications for eligibility against broad inclusion criteria. Studies using a direct, indirect, or combination approach to eliciting preferences related to cancer or cancer treatments are eligible. Data extraction will capture details of study methodology, participants, health states, and corresponding HSUVs. We will summarize our findings with descriptive analyses at this stage. A pilot review in thyroid cancer is presented to illustrate the proposed methods. Discussion. This systematic review will generate a comprehensive summary of the oncology HSUV literature. As a component of the Health Utility Book (HUB) project, we anticipate that this work will assist both health economic modelers as well as critical reviewers in the development and appraisal of CUAs in oncology.

Download Full-text