PCN42 THE HEALTH UTILITY BOOK (HUB): TOWARD A CENTRALIZED, SYSTEMATIC APPROACH TO THE IDENTIFICATION, APPRAISAL, AND USE OF HEALTH STATE UTILITY VALUES FOR REIMBURSEMENT DECISION MAKING

Abstract

The formal adoption and endorsement of cost-utility analyses (CUAs) by reimbursement authorities motivates and necessitates methodological advancement in health state utility value (HSUV) measurement and application. A large body of evidence exploring the various methods of measuring HSUVs has accumulated, inadvertently imposing challenges in identifying and using these inputs in CUAs. First, large variations in HSUVs for the same health state have been observed between studies. These differences, when applied to economic evaluations, have the potential to lead to different cost effectiveness conclusions. Second, the quality of studies that generate HSUVs has been a consistent critique in the literature. This issue is compounded by the limited guidance and methodological standards available for assessing study quality. Third, reimbursement decision-making is a jurisdiction-specific process. Thus, while a health utility study could be of high methodological quality, it is not necessarily applicable or appropriate for use in every jurisdiction. To address these issues, we have proposed the Health Utility Book (HUB) with the intent of promoting the systematic identification, critical appraisal, and appropriate use of published HSUVs. The HUB consists of an HSUV registry of published studies, a quality assessment tool for health utility studies, and a checklist for evaluating the use of published HSUVs in CUAs. We anticipate that the HUB will make a timely and important contribution to the rigorous conduct and proper use of health utility studies for reimbursement decision making, working toward a goal of health care resource allocation that reflects the preferences of the public, improves health outcomes of patients, and maintains the efficiency of health care systems.