SP2 DISCREPANCY IN HEALTH STATE UTILITY VALUES BETWEEN COST-UTILITY ANALYSIS AND REFERENCED ORIGINAL HEALTH UTILITY STUDIES IN CARDIOVASCULAR DISEASE: A REGISTRY-BASED ANALYSIS

Abstract

Cardiovascular disease (CVD) is the leading cause of noncommunicable disease deaths worldwide. CVD is associated with significant financial and humanistic burden. Cost-utility analysis (CUA) uses quality-adjusted life (QALY) as the outcome measure and is commonly used in CVD. Health state utility values (HSUVs) used in calculating QALYs play an important role in determining cost effectiveness of CVD treatments. The objective was to compare HSUVs between CUAs and referenced original HSUV studies in CVD. Tufts Cost-Effectiveness Analysis Registry is a comprehensive database including more than 7,000 CUAs studies published since 1976. We used the primary disease filter to identify all CUA studies focusing on CVD included in the registry. We reviewed and extracted original HSUV studies cited in the CUAs whenever available. The descriptions and values of health states used in the CUA were compared with those reported in the original HSUV studies to evaluate the consistency in using published HSUVs. A total of 577 CVD CUAs published between 1982 and 2016 were included in the analysis. Out of 3358 health states extracted, 642 were collected as part of the CUA and 2278 obtained from external sources. The EQ-5D (50.8%) and time trade-off (TTO) (29.1%) were the most frequently used indirect and direct methods to measure HSUVs, respectively. For the 2278 health states, only 574 (25.2%) had the same health state description and value as those in the original sources. 990 health states (43.5%) differed in both description and value for which the majority did not provide any explanation for the discrepancies. Discrepancy in the description and value for the health states between the CUA and referenced health utility studies remain an important issue in CVD. Any such discrepancy, if not justified, could affect the validity of cost effectiveness results.