Which multi-attribute utility instruments are recommended for use in cost-utility analysis? A review of national health technology assessment (HTA) guidelines

Matthew Kennedy-Martin (), Bernhard Slaap, Michael Herdman, Mandy Reenen, Tessa Kennedy-Martin, Wolfgang Greiner, Jan Busschbach and Kristina S. Boye
Additional contact information
Matthew Kennedy-Martin: Kennedy Martin Health Outcomes Ltd
Bernhard Slaap: Erasmus MC
Michael Herdman: Office of Health Economics (OHE)
Mandy Reenen: EuroQol Research Foundation
Tessa Kennedy-Martin: Kennedy Martin Health Outcomes Ltd
Wolfgang Greiner: Bielefeld University
Jan Busschbach: Erasmus MC
Kristina S. Boye: Eli Lilly and Company

The European Journal of Health Economics, 2020, vol. 21, issue 8, No 11, 1245-1257

Abstract: Abstract Background Several multi-attribute utility instruments (MAUIs) are available from which utilities can be derived for use in cost-utility analysis (CUA). This study provides a review of recommendations from national health technology assessment (HTA) agencies regarding the choice of MAUIs. Methods A list was compiled of HTA agencies that provide or refer to published official pharmacoeconomic (PE) guidelines for pricing, reimbursement or market access. The guidelines were reviewed for recommendations on the indirect calculation of utilities and categorized as: a preference for a specific MAUI; providing no MAUI preference, but providing examples of suitable MAUIs and/or recommending the use of national value sets; and recommending CUA, but not providing examples of MAUIs. Results Thirty-four PE guidelines were included for review. MAUIs named for use in CUA: EQ-5D (n = 29 guidelines), the SF-6D (n = 11), HUI (n = 10), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). EQ-5D was a preferred MAUI in 15 guidelines. Alongside the EQ-5D, the HUI was a preferred MAUI in one guideline, with DALY disability weights mentioned in another. Fourteen guidelines expressed no preference for a specific MAUI, but provided examples: EQ-5D (n = 14), SF-6D (n = 11), HUI (n = 9), QWB (n = 3), AQoL (n = 2), CHU9D (n = 1). Of those that did not specify a particular MAUI, 12 preferred calculating utilities using national preference weights. Conclusions The EQ-5D, HUI, and SF-6D were the three MAUIs most frequently mentioned in guidelines. The most commonly cited MAUI (in 85% of PE guidelines) was EQ-5D, either as a preferred MAUI or as an example of a suitable MAUI for use in CUA in HTA.

Keywords: Health technology assessment; Cost-utility analysis; Multi-attribute utility instruments; Pharmacoeconomics; Guidelines; Utility (search for similar items in EconPapers)
JEL-codes: I11 I18 (search for similar items in EconPapers)
Date: 2020
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Citations: View citations in EconPapers (18)

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DOI: 10.1007/s10198-020-01195-8

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