Investigation of Evidence Sources for Health-Related Quality of Life in Cost-Utility Analysis of Pharmaceuticals in Japan

Abstract

ObjectiveTo provide an overview of how current utility values were obtained in the cost-utility analysis (CUA) for pharmaceuticals in Japan on the basis of methodological guidelines developed in England and Wales, Australia, Canada, France, and Japan by conducting a systematic review of the published literature. MethodsWe searched and reviewed CUAs conducted for pharmaceuticals in Japan, reporting the results as cost per quality-adjusted life-year (QALY). The databases we used were PubMed, EconLit, Centre for Reviews and Dissemination, and the Japan Medical Abstracts Society. The search terms were “QALY” and “Japan” or “cost utility” and “Japan” in the PubMed database, Centre for Reviews and Dissemination, and EconLit. In the search on the Japan Medical Abstracts Society database, we used the term “QALY.” ResultsIn total, 41 CUA articles met the selection criteria and the most common method of obtaining utility values was derived from the published literature (31 CUAs, 168 utility values). Five CUAs were elicited by directly asking the participants regarding their own health state, and four CUAs used “mapping” techniques in which utility values were linked to clinical results. The most commonly used instrument was the EuroQol five-dimensional questionnaire followed by the time-trade-off. A few CUAs mentioned how they selected the literature for the utility values, and some utility values were combined across different sources, using different methods, and obtained from different locations. ConclusionsPractical methodological guidelines need to be developed to provide standardized methods of presenting the procedure of using utility values from the literature. Although transferability of utility values across jurisdictions has not been discussed fully, this topic should be covered in methodological guidelines and recommend best practices for evaluations.