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. 2019 Feb;20(1):99-105.
doi: 10.1007/s10198-018-0987-x. Epub 2018 Jun 14.

Impact of mapped EQ-5D utilities on cost-effectiveness analysis: in the case of dialysis treatments

Fan Yang  1 , Nancy Devlin  2 , Nan Luo  3
Affiliations

Impact of mapped EQ-5D utilities on cost-effectiveness analysis: in the case of dialysis treatments

Fan Yang et al. Eur J Health Econ. 2019 Feb.

Abstract

Objectives: This study aimed to evaluate the performance of EQ-5D data mapped from SF-12 in terms of estimating cost effectiveness in cost-utility analysis (CUA). The comparability of SF-6D (derived from SF-12) was also assessed.

Methods: Incremental quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated based on two Markov models assessing the cost effectiveness of haemodialysis (HD) and peritoneal dialysis (PD) using utility values based on EQ-5D-5L, EQ-5D using three direct-mapping algorithms and two response-mapping algorithms (mEQ-5D), and SF-6D. Bootstrap method was used to estimate the 95% confidence interval (percentile method) of incremental QALYs and ICERs with 1000 replications for the utilities.

Results: In both models, compared to the observed EQ-5D values, mEQ-5D values expressed much lower incremental QALYs (range - 14.9 to - 33.2%) and much higher ICERs (range 17.5 to 49.7%). SF-6D also estimated lower incremental QALYs (- 29.0 and - 14.9%) and higher ICERs (40.9 and 17.5%) than did the observed EQ-5D. The 95% confidence interval of incremental QALYs and ICERs confirmed the lower incremental QALYs and higher ICERs estimated using mEQ-5D and SF-6D.

Conclusion: Compared to observed EQ-5D, EQ-5D mapped from SF-12 and SF-6D would under-estimate the QALYs gained in cost-utility analysis and thus lead to higher ICERs. It would be more sensible to conduct CUA studies using directly collected EQ-5D data and to designate one single preference-based measure as reference case in a jurisdiction to achieve consistency in healthcare decision-making.

Keywords: Cost-effectiveness; Dialysis; EQ-5D; Mapping; SF-6D.

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Conflict of interest statement

ND is an employee of the Office of Health Economics, a registered charity, which receives funding from a variety of sources, including the Association of the British Pharmaceutical Industry. ND and NL are members of the EuroQol Group.

Figures

Fig. 1
Fig. 1
Box plots of utilities for HD and PD states used in model 1 (a) and model 2 (b)
See this image and copyright information in PMC

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