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Assessing Health State Utilities in Elderly Patients at Cardiovascular Risk

Author

Listed:
  • Wolfgang C. Winkelmayer

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, wwinkelmayer@partners.org)

  • Joshua S. Benner

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston)

  • Robert J. Glynn

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston)

  • Sebastian Schneeweiss

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston)

  • Philip S. Wang

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston)

  • M. Alan Brookhart

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston)

  • Raisa Levin

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston)

  • Joseph D. Jackson

    (Bristol-Myers Squibb, Princeton, New Jersey)

  • Jerry Avorn

    (Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston)

Abstract

Background . Health state preferences can be a crucial component of cost-effectiveness analyses, but off-the-shelf health state utilities specifically for older people are not available. Objectives . Among participants in PROSPER, a trial of pravastatin in patients > 70 years, the authors assessed utilities for the health states that were relevant for the trial’s cost-utility analysis. Subjects and Methods . The authors cross-sectionally administered the Health Utilities Index, Mark 3 (HUI) to all PROSPER participants to assess each patient’s health state at the time of interview; they then used the scale’s multiattribute utility function to estimate the resulting utilities. The population was then stratified into 3 health states, and the mean utility function for each was calculated: recent myocardial infarction (MI, within 3 months), previous MI ( > 3 months), or no prior MI. Linear and logistic regression were used to control for potential demographic and clinical characteristics. Results . Of the 5804 patients enrolled in the trial, 4677 were administered the HUI instrument. The likelihood of having a complete HUI response set decreased with higher age ( P 3 months previously, and 89 (2.6%) had an MI within 3 months. The mean (median) utilities were virtually identical for these states: 0.75 (0.84), 0.74 (0.84), and 0.74 (0.84), respectively. From multivariate analyses, utilities decreased with higher age and the presence of several other comorbidities (diabetes, stroke, peripheral vascular disease); women had lower utilities than men (all P

Suggested Citation

  • Wolfgang C. Winkelmayer & Joshua S. Benner & Robert J. Glynn & Sebastian Schneeweiss & Philip S. Wang & M. Alan Brookhart & Raisa Levin & Joseph D. Jackson & Jerry Avorn, 2006. "Assessing Health State Utilities in Elderly Patients at Cardiovascular Risk," Medical Decision Making, , vol. 26(3), pages 247-254, May.
    • Handle: RePEc:sae:medema:v:26:y:2006:i:3:p:247-254
    DOI: 10.1177/0272989X06288685
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    References listed on IDEAS

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    1. W Furlong & D Feeny & G Torrance & C Goldsmith & S DePauw & Z Zhu & M Denton & M Boyle, 1998. "Multiplicative Multi-Attribute Utility Function for the Health Utilities Index Mark 3 (HUI3) System: A Technical Report," Centre for Health Economics and Policy Analysis Working Paper Series 1998-11, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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