The remarkably frequent use of EQ-5D in non-economic research

Introduction EQ-5D is an instrument which has been utilized for a variety of purposes, including in health-economic appraisals as an input into quality-adjusted life year (QALY) calculations. Indeed, it is the most-widely applied instrument for health-economic appraisal worldwide, and is recommended for use in QALY calculations by many national Health Technology Assessment (HTA) agencies. There is also a growing body of evidence for its usefulness in a variety of settings other than economic appraisals, but such use has not been well-documented. This study addresses this issue and documents how EQ-5D has been applied in both the non-economic and economic contexts. Methods The PubMed database was searched using the terms ‘EQ-5D’, ‘EQ-5D AND cost’, and ‘EQ-5D AND cost AND QALY’ from 1 January 1980 to 31 December 2019. We concentrated on 2019 publications for more detailed analyses. All the data collected for 2019 were downloaded and collected in EndNote. For 2019 only, we classified economic and non-economic use based on the inclusion of ‘cost’. We also checked by manual inspection whether the search terms were suitable in correctly identifying economic and non-economic use. Variants of the non-economic use of EQ-5D were classified as follows: (a) as a quality of life outcome measure; (b) as a tool for methodological research; (c) methodological issues of EQ-5D itself; (d) comparisons with other quality of life questionnaires; (e) mapping studies; (f) value sets; (g) alongside costs but no QALY calculated; and (h) other. Results The first publication found was from 1990. Up to and including 2019, 10,817 publications were identified, of which more than two in three did not contain any reference to costs or QALYs. In 2019, a total of 1409 manuscripts were identified, of which 239 were specifically for EQ-5D-5L. Four hundred and seven (28.9%) included some form of ‘costs’ and 157 (11.1%) both ‘costs’ AND ‘QALYs’ terms. For EQ-5D-5L, the corresponding numbers were 104 (43.5%) and 29 (12.1%), respectively. After manually checking all the 1409 papers, three were duplicated records, which were omitted. In the remaining 1406 papers, only 40 (2.8%) contained the term ‘cost’, but not ‘cost per QALY’, and only 117 (8.3%) were identifiable as economic evaluations using the term ‘cost per QALY’. Most non-economic use of EQ-5D was as a quality-of-life outcome measure (72.8%). Other applications were: as a tool for methodological research (6.7%); comparison studies (3.7%); EQ-5D methodological issues (3.5%); containing costs but not QALYs (2.8%); mapping (1.3%); value sets (0.4%); and other papers (0.4%). Conclusions The majority of the studies retrieved, covering a wide variety of research areas, reported upon the non-economic use of EQ-5D. Despite being the most-used instrument worldwide for QALY calculations, economic appraisal accounted for only a small, but important, part of published use.

Economic appraisal in public healthcare: assessing efficiency and equity

This chapter is an introduction to economic appraisal. It explains underlying concepts, describes methods used, and discusses the application to public health. Economic appraisal comprises techniques that weigh up the costs of an action, such as providing a public health intervention to an at-risk population group, against the benefits that it provides. Important underlying principles are opportunity cost, social versus private costs and benefits, marginal costs and benefits, efficiency, and equity. There are different types of economic appraisal, each of which measures the costs and benefits of options being compared. Measuring costs involves identifying and describing resource use changes, quantifying them in physical units and valuing them. Issues in cost measurement include use of macro or micro-costing and dealing with inflation and time preference. There are several approaches that can be used to measure benefits depending on the type of economic appraisal being used; a measure of special interest is quality-adjusted life years (QALYs). Modelling is often used in economic appraisal to combine data on the costs and benefits of an intervention. Given the inherent uncertainties involved in economic appraisal it is good practice to undertake sensitivity analyses that investigate the impact of uncertainty. Methodological challenges in undertaking economic appraisals of public health interventions include the importance of equity and inequality considerations, establishing robust evidence of the effect of public health programmes, the relevance of QALYs, and accounting for multisectoral costs and benefits.

FEATURES OF GEOLOGICAL STUDY AND DEVELOPMENT OF ACCUMULATIONS WITH HARD-TO-RECOVER RESERVES IN THE PRE-JURASSIC PLAY OF WEST SIBERIA IN RELATION TO THE EXPERIENCE OF GEOLOGICAL-ECONOMIC APPRAISAL

Within the West Siberian petroleum basin, more than 60 oil and gas fields have been discovered in the pre-Jurassic basement formations. Reserves of these fields are referred to hard-to-recover ones due to both the complexity of the geological structure and the need to apply non-standard approaches at all stages of their search, exploration and development. Development of the Pre-Jurassic complex is one of the main directions in replenishing the raw material base of hydrocarbons in West Siberia, where production from traditional fields is steadily declining. The article summarizes the data on geological features and petroleum potential of the Pre-Jurassic complex of the West Siberian basin. Based on the analysis of results of exploration and development of accumulations, proposals on various geological and technological parameters are formulated when performing the geological and economic appraisal of promising targets with similar predicted characteristics.