Which multi-attribute utility instruments are recommended for use in cost-utility analysis? A review of national health
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ORIGINAL PAPER
Which multi‑attribute utility instruments are recommended for use in cost‑utility analysis? A review of national health technology assessment (HTA) guidelines Matthew Kennedy‑Martin1 · Bernhard Slaap2,3 · Michael Herdman4 · Mandy van Reenen3 · Tessa Kennedy‑Martin1 · Wolfgang Greiner5 · Jan Busschbach2 · Kristina S. Boye6 Received: 6 September 2019 / Accepted: 25 April 2020 © The Author(s) 2020
Abstract Background Several multi-attribute utility instruments (MAUIs) are available from which utilities can be derived for use in cost-utility analysis (CUA). This study provides a review of recommendations from national health technology assessment (HTA) agencies regarding the choice of MAUIs. Methods A list was compiled of HTA agencies that provide or refer to published official pharmacoeconomic (PE) guidelines for pricing, reimbursement or market access. The guidelines were reviewed for recommendations on the indirect calculation of utilities and categorized as: a preference for a specific MAUI; providing no MAUI preference, but providing examples of suitable MAUIs and/or recommending the use of national value sets; and recommending CUA, but not providing examples of MAUIs. Results Thirty-four PE guidelines were included for review. MAUIs named for use in CUA: EQ-5D (n = 29 guidelines), the SF-6D (n = 11), HUI (n = 10), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). EQ-5D was a preferred MAUI in 15 guidelines. Alongside the EQ-5D, the HUI was a preferred MAUI in one guideline, with DALY disability weights mentioned in another. Fourteen guidelines expressed no preference for a specific MAUI, but provided examples: EQ-5D (n = 14), SF-6D (n = 11), HUI (n = 9), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). Of those that did not specify a particular MAUI, 12 preferred calculating utilities using national preference weights. Conclusions The EQ-5D, HUI, and SF-6D were the three MAUIs most frequently mentioned in guidelines. The most commonly cited MAUI (in 85% of PE guidelines) was EQ-5D, either as a preferred MAUI or as an example of a suitable MAUI for use in CUA in HTA. Keywords Health technology assessment · Cost-utility analysis · Multi-attribute utility instruments · Pharmacoeconomics · Guidelines · Utility JEL Classification i11, i18 * Matthew Kennedy‑Martin [email protected] 1
Kennedy Martin Health Outcomes Ltd, Suite 404, The Dock Hub, Wilbury Villas, Hove BN3 6AH, UK
2
Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
3
EuroQol Research Foundation, Rotterdam, The Netherlands
4
Office of Health Economics (OHE), London, UK
5
Department of Health Economics at the School of Public Health, Bielefeld University, Bielefeld, Germany
6
Eli Lilly and Company, Indianapolis, IN, USA
Introduction Several methods of economic evaluation are utilized in health technology assessment (HTA), including cost-utility analysis (CUA), a form of cost-effectiveness analysis that assesses the value of interventions, typically according to the in
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