The Impact of Differences in EQ-5D and SF-6D Utility Scores on the Acceptability of Cost-Utility Ratios: Results across Five Trial-Based Cost-Utility Studies

Manuela Joore*, Danielle Brunenberg, Patricia Nelemans, Emiel Wouters, Petra Kuijpers, Adriaan Honig, Danielle Willems, Peter de Leeuw, Johan L. Severens, Annelies Boonen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objective: This article investigates whether differences in utility scores based on the EQ-5D and the SF-6D have impact on the incremental cost-utility ratios in five distinct patient groups. Methods: We used five empirical data sets of trial-based cost-utility studies that included patients with different disease conditions and severity (musculoskeletal disease, cardiovascular pulmonary disease, and psychological disorders) to calculate differences in quality-adjusted life-years (QALYs) based on EQ-5D and SF-6D utility scores. We compared incremental QALYs, incremental cost-utility ratios, and the probability that the incremental cost-utility ratio was acceptable within and across the data sets. Results: We observed small differences in incremental QALYs, but large differences in the incremental cost-utility ratios and in the probability that these ratios were acceptable at a given threshold, in the majority of the presented cost-utility analyses. More specifically, in the patient groups with relatively mild health conditions the probability of acceptance of the incremental cost-utility ratio was considerably larger when using the EQ-5D to estimate utility. While in the patient groups with worse health conditions the probability of acceptance of the incremental cost-utility ratio was considerably larger when using the SF-6D to estimate utility. Conclusions: Much of the appeal in using QALYs as measure of effectiveness in economic evaluations is in the comparability across conditions and interventions. The incomparability of the results of cost-utility analyses using different instruments to estimate a single index value for health severely undermines this aspect and reduces the credibility of the use of incremental cost-utility ratios for decision-making.
Original languageEnglish
Pages (from-to)222-229
JournalValue in Health
Volume13
Issue number2
DOIs
Publication statusPublished - 2010

Keywords

  • cost-utility
  • EQ-5D
  • SF-6D
  • utility

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