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The Implications of Using US-Specific EQ-5D Preference Weights for Cost-Effectiveness Evaluation

Author

Listed:
  • Katia Noyes

    (Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York, katia_noyes@urmc.rochester.edu)

  • Andrew W. Dick

    (Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York, The RAND Corporation, Pittsburgh, Pennsylvania)

  • Robert G. Holloway

    (Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York, Department of Neurology, University of Rochester School of Medicine, Rochester, New York)

Abstract

Objective. The objective of this study is to examine the effect of country-specific EQ-5D preference weights on the cost-effectiveness (CE) of initial pramipexole versus levodopa strategy in patients with Parkinson disease (PD). Methods. A total of 301 subjects with PD were randomized to initial pramipexole or levodopa and followed every 3 months over a 4-year period. Subjects' health-related quality of life (HRQOL) was measured using EQ-5D, and their health preferences were calculated using both the UK and US sets of weights. The effectiveness of pramipexole was defined as the additional quality-adjusted life-years (QALY) gained compared to levodopa and was estimated as the area between the treatment-specific HRQOL profiles adjusted for baseline difference. Results. Using the original UK weights, the incremental effectiveness was 0.155 QALYs, which resulted in the incremental CE ratio (ICER) of $42,989/QALY and a probability that pramipexole was cost-effective relative to levodopa of 0.57, 0.77, and 0.82 when a QALY was valued at $50,000, $100,000, and $150,000, respectively. Using the US-specific weights resulted in lower incremental effectiveness (0.062 QALYs), higher ICER ($108,498/QALY), and a lower probability that pramipexole was cost-effective compared to levodopa at any valuation of QALY (0.23 for $50,000, 0.48 for $100,000, and 0.58 for $150,000). Conclusions. Country-specific preference weights in clinical-economic trials might have important effects on estimates of incremental cost-effectiveness. Using US preference weights rather than UK preference weights reduced the probability that pramipexole was cost-effective compared to levodopa.

Suggested Citation

  • Katia Noyes & Andrew W. Dick & Robert G. Holloway, 2007. "The Implications of Using US-Specific EQ-5D Preference Weights for Cost-Effectiveness Evaluation," Medical Decision Making, , vol. 27(3), pages 327-334, May.
    • Handle: RePEc:sae:medema:v:27:y:2007:i:3:p:327-334
    DOI: 10.1177/0272989X07301822
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. William J Furlong & David H. Feeny & George W. Torrance & Ronald D. Barr, 2001. "The Health Utilities Index (HUI®) System for Assessing Health-Related Quality of Life in Clinical Studies," Centre for Health Economics and Policy Analysis Working Paper Series 2001-02, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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    1. Munir A. Khan & Jeff Richardson, 2019. "Is the Validity of Cost Utility Analysis Improved When Utility is Measured by an Instrument with ‘Home-Country’ Weights? Evidence from Six Western Countries," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 145(1), pages 1-15, August.
    2. Ivar Kristiansen & Kerstin Bingefors & Dag Nyholm & Dag Isacson, 2009. "Short-term cost and health consequences of duodenal levodopa infusion in advanced Parkinson’s disease in Sweden," Applied Health Economics and Health Policy, Springer, vol. 7(3), pages 167-180, September.
    3. Przemysław Holko & Paweł Kawalec & Małgorzata Mossakowska & Andrzej Pilc, 2016. "Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-21, December.
    4. Liv Ariane Augestad & Kim Rand-Hendriksen & Ivar Sønbø Kristiansen & Knut Stavem, 2012. "Impact of Transformation of Negative Values and Regression Models on Differences Between the UK and US EQ-5D Time Trade-Off Value Sets," PharmacoEconomics, Springer, vol. 30(12), pages 1203-1214, December.
    5. Liv Augestad & Kim Rand-Hendriksen & Ivar Kristiansen & Knut Stavem, 2012. "Impact of Transformation of Negative Values and Regression Models on Differences Between the UK and US EQ-5D Time Trade-Off Value Sets," PharmacoEconomics, Springer, vol. 30(12), pages 1203-1214, December.

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