PCV38 - A Systematic Review of Cardiovascular Event Utilities in Asia

Abstract

This systematic literature review (SLR) aimed to identify and evaluate utilities reported for stroke, acute coronary syndrome (ACS), and heart failure in Asia. A SLR was conducted to identify English-language articles in Embase, PubMed, and the grey literature published between 1992 and August 2015 using keywords for cardiovascular (CV) events and utilities. Primary studies reporting utilities for stroke, ACS (including myocardial infarction and angina), and heart failure in adults were included. Utilities were evaluated by population, health state, and methodology. Twenty-three articles reported on studies in Asia, including South Korea (8), China (5), Thailand (3), Taiwan (2), India, Japan, Malaysia, Singapore, and Vietnam (1 each). Nearly all studies (20/23) reported EQ-5D utilities and only two used direct methods of elicitation; all utilities were elicited from patients experiencing the conditions rather than general population respondents. Seventeen studies reported utility values for stroke, 12 studies for ACS, and no studies reported on heart failure. Average utilities ranged widely for stroke (-1.99–0.96) and ACS (0.11–1). These wide ranges were seen with most methods of elicitation (EQ-5D [n=20]: -0.14–1; standard gamble [n=3]: -1.99–0.72; HUI-3 [n=1]: -0.23–0.62). SF-6D range was narrow (0.68–0.69) with all values from the same ACS population (n=3 papers). In stroke, severe disease was associated with lower utility values (-1.57–0.49; n=3) than mild disease (0.62 to 0.96; n=4); disease severity was not reported for ACS. This SLR identified a wide range of utility values for stroke and ACS in Asia. Method of elicitation and severity of disease may impact utility values. Substantial data gaps were observed, particularly for heart failure, levels of disease severity for ACS, and direct methods of utility elicitation; further study is needed to determine whether data from outside Asia can be used to fill such gaps.