MS4: A SYSTEMATIC REVIEW OF HEALTH STATE VALUES FOR OSTEOPOROSIS RELATED CONDITIONS

Abstract

An important weakness of economic models in the field of osteoporosis has been the dependence on assumptions or expert judgments rather than empirical estimates for the utility values of key health events associated with osteoporosis. OBJECTIVES: This paper seeks to identify the best available utility estimates for health states associated with osteoporosis and make recommendations about their use. METHODS: This review has been based on a systematic search of the main literature databases. Studies meeting the inclusion criteria have been reviewed in terms of the appropriateness of the valuation technique, the validity of the descriptive system (where one was used), the number and type of respondents and overall study quality. RESULTS: Twenty-three estimates of health state values (HSVs) were found across four conditions from five studies. These empirical estimates were found to differ significantly from the commonly used assumptions in published economic models of interventions or osteoporosis, but with a wide variation between estimates for the same state (0.32 to 0.80) for vertebral fracture states). This variation can be partly explained by differences in the valuation technique, health state descriptions and the background and perspective of the respondent, and leaves considerable scope for discretion that could be abused. There are also problems in applying values obtained from these studies to the populations being examined in economic models and a particular difficulty in predicting the HSV in those who avoid a fracture as a result of an intervention. CONCLUSION: The review recommends a set of HSVs as part of a reference case for use in economic models. Due to the paucity of good quality estimates in this area, further recommendations are made regarding the design of future studies to collect HSVs relevant to economic models.