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Populating an economic model with health state utility values: moving towards better practice

Ara, R. and Brazier, J. (2010) Populating an economic model with health state utility values: moving towards better practice. Discussion Paper. Value in Health

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Background: When estimating health state utility values (HSUV) for multiple health conditions, the alternative models used to combine these data can produce very different values. Results generated using a baseline of perfect health are not comparable with those generated using a baseline adjusted for not having the health condition taking into account age and gender. Despite this, there is no guidance on the preferred techniques that should be used and very little research describing the effect on cost per QALY results.

Methods: Using a cardiovascular disease (CVD) model and cost per QALY thresholds, we assess the consequence of using different baseline health state utility profiles (perfect health, individuals with no history of CVD, general population) in conjunction with three models (minimum, additive, multiplicative) frequently used to estimate proxy scores for multiple health conditions.

Results: Assuming a baseline of perfect health ignores the natural decline in quality of life associated with co-morbidities, over-estimating the benefits of treatment to such an extent it could potentially influence a threshold policy decision. The minimum model biases results in favour of younger aged cohorts while the additive and multiplicative technique produced similar results.

Although further research in additional health conditions is required to support our findings, this pilot study highlights the urgent need for analysts to conform to an agreed reference case and provides initial recommendations for better practice. We demonstrate that in CVD, if data are not available from individuals without the health condition, HSUVs from the general population provide a reasonable approximation.

Item Type: Monograph (Discussion Paper)
Copyright, Publisher and Additional Information: PubMed ID for published paper PMID: 20230546
Keywords: health-state utility, health economics methods, methodology, decision models, health surveys
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > Health Economics and Decision Science > HEDS Discussion Paper Series
Depositing User: ScHARR / HEDS (Sheffield)
Date Deposited: 04 Aug 2010 08:34
Last Modified: 06 Jun 2014 11:42
Published Version: http://dx.doi.org/10.1111/j.1524-4733.2010.00700.x
Status: Published
Publisher: Value in Health
Identification Number: HEDS Discussion Paper 09/11
URI: http://eprints.whiterose.ac.uk/id/eprint/11096

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