Estimating Cost-Effectiveness Using Alternative Preference-Based Scores and Within-Trial Methods: Exploring the Dynamics of the Quality-Adjusted Life-Year Using the EQ-5D 5-Level Version and Recovering Quality of Life Utility Index

Franklin, Matthew; Hunter, Rachael; Enrique, Ángel; Palacios, Jorge; Richards, Derek

doi:10.1016/j.jval.2021.11.1358

Cited by 8 publications

(8 citation statements)

References 74 publications

(118 reference statements)

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“…22 estimates of mean QalYs were adjusted using regression methods with the baseline eQ-5d utility score as the independent variable. 23 utilities were set to zero at the studied timepoint (four or 12 months) if the participant had died in the period since the last data collection timepoint. 24 Statistical analysis.…”

Section: Methodsmentioning

confidence: 99%

Cost-utility analysis of cemented hemiarthroplasty versus hydroxyapatite-coated uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures

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Petrou

Fernandez

et al. 2022

The Bone & Joint Journal

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Aims The aim of this study was to compare the cost-effectiveness of cemented hemiarthroplasty (HA) versus hydroxyapatite-coated uncemented HA for the treatment of displaced intracapsular hip fractures in older adults. Methods A within-trial economic evaluation was conducted based on data collected from the World Hip Trauma Evaluation 5 (WHiTE 5) multicentre randomized controlled trial in the UK. Resource use was measured over 12 months post-randomization using trial case report forms and participant-completed questionnaires. Cost-effectiveness was reported in terms of incremental cost per quality-adjusted life year (QALY) gained from the NHS and personal social service perspective. Methodological uncertainty was addressed using sensitivity analysis, while decision uncertainty was represented graphically using confidence ellipses and cost-effectiveness acceptability curves. Results The base-case analysis showed that cemented implants were cost-saving (mean cost difference -£961 (95% confidence interval (CI) -£2,292 to £370)) and increased QALYs (mean QALY difference 0.010 (95% CI 0.002 to 0.017)) when compared to uncemented implants. The probability of the cemented implant being cost-effective approximated between 95% and 97% at alternative cost-effectiveness thresholds held by decision-makers, and its net monetary benefit was positive. The findings remained robust against all the pre-planned sensitivity analyses. Conclusion This study shows that cemented HA is cost-effective compared with hydroxyapatite-coated uncemented HA in older adults with displaced intracapsular hip fractures. Cite this article: Bone Joint J 2022;104-B(8):922–928.

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Section: Methodsmentioning

confidence: 99%

Cost-utility analysis of cemented hemiarthroplasty versus hydroxyapatite-coated uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures

Png

Petrou

Fernandez

et al. 2022

The Bone & Joint Journal

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“…Imputations were drawn from a pool of 5 donors (nearest neighbors). 27,28 Missing costs were limited (1.5% missing) and were assumed to be zero because it is most common to have no health care use.…”

Section: Cost-effectivenessmentioning

confidence: 99%

Cost-effectiveness of Prednisolone to Treat Bell Palsy in Children

Xiong

Herd

et al. 2023

Neurology

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Background and Objectives:Bell’s palsy is the third most frequent diagnosis in children with sudden onset neurological dysfunction. The cost-effectiveness of treating Bell’s palsy with prednisolone in children is unknown. We aimed to assess the cost-effectiveness of prednisolone in treating Bell’s Palsy in children compared with placebo.Methods:This economic evaluation was a prospectively planned secondary analysis of a double-blinded, randomized, placebo-controlled superiority trial (BellPIC) conducted from 2015 to 2020. Time horizon was 6 months since randomization. Children aged 6 months to <18 years who presented within 72 hours of onset of clinician diagnosed Bell’s palsy and who completed the trial were included (N=180). Interventions were oral prednisolone, or taste matched placebo administered for 10 days. Incremental cost-effectiveness ratio comparing prednisolone with placebo was estimated. Costs were considered from a healthcare sector perspective and included Bell’s palsy related medication cost, doctor visits and medical tests. Effectiveness was measured using quality-adjusted life-years (QALYs) based on Child Health Utility 9D. Nonparametric bootstrapping was performed to capture uncertainties. Pre-specified sub-group analysis by age 12-18 years versus <12 years was conducted.Results:The mean cost per patient was A$760 in the prednisolone group and A$693 in the placebo group over the 6-month period (difference A$66, 95% confidence interval [CI]: -A$47, A$179). QALYs over 6-months was 0.45 in the prednisolone group and 0.44 in the placebo group (difference 0.01, 95%CI: -0.01, 0.03). The incremental cost to achieve one additional recovery was estimated to be A$1577 using prednisolone compared with placebo, and cost per additional QALY gained was A$6625 using prednisolone compared with placebo. Given a conventional willingness-to-pay threshold of A$50,000 per QALY gained (equivalent to US$35,000 or £28,000), prednisolone is very likely cost-effective (probability is 83%), . Sub-group analysis suggests that this was primarily driven by the high probability of prednisolone being cost-effective in children aged 12-18 years (probability is 98%) and much less so for those <12 years (probability is 51%).Discussion:This provides new evidence to stakeholders and policy makers when considering whether to make prednisolone available in treating Bell’s palsy in children aged 12-18 years.Trial Registration:Australian New Zealand Clinical Trials Registry ACTRN12615000563561.

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“…A UK preference-based value set has been developed to calculate QALYs from seven ReQoL-10 items: the ReQoL Utility Index (ReQoL-UI) [ 22 ]. Key differences in ReQoL-UI and EQ-5D-5L design, utility score distributions, psychometric properties, and subsequently estimated QALYs have been assessed and discussed [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Enabling QALY estimation in mental health trials and care settings: mapping from the PHQ-9 and GAD-7 to the ReQoL-UI or EQ-5D-5L using mixture models

Franklin

Alava

2023

Qual Life Res

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Purpose Patient-reported outcome measures (PROMs) are commonly collected in trials and some care settings, but preference-based PROMs required for economic evaluation are often missing. For these situations, mapping models are needed to predict preference-based (aka utility) scores. Our objective is to develop a series of mapping models to predict preference-based scores from two mental health PROMs: Patient Health Questionnaire-9 (PHQ-9; depression) and Generalised Anxiety Questionnaire-7 (GAD-7; anxiety). We focus on preference-based scores for the more physical-health-focussed EQ-5D (five-level England and US value set, and three-level UK cross-walk) and more mental-health-focussed Recovering Quality-of-Life Utility Index (ReQoL-UI). Methods We used trial data from the Improving Access to Psychological Therapies (IAPT) mental health services (now called NHS Talking Therapies), England, with a focus on people with depression and/or anxiety caseness. We estimated adjusted limited dependent variable or beta mixture models (ALDVMMs or Betamix, respectively) using GAD-7, PHQ-9, age, and sex as covariates. We followed ISPOR mapping guidance, including assessing model fit using statistical and graphical techniques. Results Over six data collection time-points between baseline and 12-months, 1340 observed values (N ≤ 353) were available for analysis. The best fitting ALDVMMs had 4-components with covariates of PHQ-9, GAD-7, sex, and age; age was not a probability variable for the final ReQoL-UI mapping model. Betamix had practical benefits over ALDVMMs only when mapping to the US value set. Conclusion Our mapping functions can predict EQ-5D-5L or ReQoL-UI related utility scores for QALY estimation as a function of variables routinely collected within mental health services or trials, such as the PHQ-9 and/or GAD-7.

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Estimating Cost-Effectiveness Using Alternative Preference-Based Scores and Within-Trial Methods: Exploring the Dynamics of the Quality-Adjusted Life-Year Using the EQ-5D 5-Level Version and Recovering Quality of Life Utility Index

Cited by 8 publications

References 74 publications

Cost-utility analysis of cemented hemiarthroplasty versus hydroxyapatite-coated uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures

Cost-utility analysis of cemented hemiarthroplasty versus hydroxyapatite-coated uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures

Cost-effectiveness of Prednisolone to Treat Bell Palsy in Children

Enabling QALY estimation in mental health trials and care settings: mapping from the PHQ-9 and GAD-7 to the ReQoL-UI or EQ-5D-5L using mixture models

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