The impact of multiple sclerosis severity on health state utility values: Evidence from Australia

Ahmad, Habibah; Taylor, Bruce; Mei, Ingrid van der; Colman, Sam; O'Leary, BA; Breslin, Monique; Palmer, Andrew J.

doi:10.1177/1352458516672014

Cited by 29 publications

(41 citation statements)

References 32 publications

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“… 37 The EQ-VAS scores observed here are relatively close to those reported in a North American registry of patients treated with fingolimod. 38 We observed a strong negative association between QoL determined with the EQ-VAS and with disability measured with the EDSS, consistent with previous studies with this 39 – 41 and other 6 , 42 measures of QoL. The relationship between treatment satisfaction and QoL has previously been demonstrated in other pathologies, including hypertension, 20 diabetes, 21 and allergic rhinitis, 22 and is to be expected.…”

Section: Discussionsupporting

confidence: 90%

Treatment satisfaction and quality of life in patients treated with fingolimod

Mékiès¹,

Heinzlef²,

Jenny

et al. 2018

PPA

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BackgroundThe development of oral treatments for relapsing–remitting multiple sclerosis (RRMS) may alter patient satisfaction and quality of life (QoL). The aim of this survey was to evaluate treatment satisfaction and QoL in patients treated with fingolimod in everyday clinical practice in France.MethodsNeurologists treating MS in France were invited to participate in the survey by telephone. Each physician was expected to recruit up to six patients with RRMS currently being treated with fingolimod. Enrolled patients were asked to complete the Treatment Satisfaction Questionnaire for Medication (TSQM), the 3-level 5-dimension EuroQoL instrument, as well as specific questions on change in QoL since starting fingolimod. Factors associated with the TSQM score were evaluated using multiple logistic regression analysis.ResultsTwo hundred and fourteen patients were recruited by 54 neurologists. The mean age of the patients was 41.6±10.0 years, and 73.4% of them were women. During the hospitalization for initiation of fingolimod treatment, 70.1% of patients had received information on MS, 76.6% had received information on fingolimod, and 20.7% had participated in a therapeutic education program. The two variables with the strongest associations with high TSQM scores (≥75) were a positive perception of initial hospitalization (hazard ratio: 10.27) and receiving information on MS during hospitalization (hazard ratio: 5.70). The mean EQ-visual analog scale score was 71.6±16.8. The mean EQ-visual analog scale score was significantly higher in patients satisfied with their treatment (75.8±15.2) compared to those unsatisfied with treatment (66.6±17.2). The proportion of patients who reported an improvement in their capacity to plan for the future was higher in satisfied (72.6%) than in unsatisfied patients (49.5%).ConclusionThe majority of patients treated with fingolimod are satisfied with their treatment. Treatment satisfaction is associated with better self-rated QoL and an improvement of QoL since starting treatment.

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Section: Discussionsupporting

confidence: 90%

Treatment satisfaction and quality of life in patients treated with fingolimod

Mékiès¹,

Heinzlef²,

Jenny

et al. 2018

PPA

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“…Finally, we did not independently consider a category of ‘no disability’ due to small numbers 41 and to match up with our previous work. 3,27 However, future work on costs, utilities, probabilities and modelling will attempt to split ‘no disability’ from ‘mild disability’ as we include larger sample sizes.…”

Section: Discussionmentioning

confidence: 99%

“…While uncertainties exist in our results, the estimates reported in our study are consistent with the findings of the existing literature in the field. We recommend the use of these specific Australian transition probability estimates (with some degree of caution) in future local health economic evaluations due to three key reasons: (1) no alternative data are available from other similar nations that match up with our previous work on costs and health utilities in MS; 3,27 (2) transition probabilities may differ between nations due to different treatment patterns and hence the different intervention effects; and (3) the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) recommends the use of locally driven input parameters when they are available, especially when local treatment patterns may differ from international data. 43…”

Section: Discussionmentioning

confidence: 99%

“…The details on how EDSS was measured for each study are provided elsewhere. 21,23 In line with previous studies in the health economics of MS, 3,24–27 we classified participants into three broad disability groups based on their EDSS scores: no/mild disability (EDSS 0–3.5), moderate disability (EDSS 4–6.0), and severe disability (EDSS 6.5–9.5). Our analysis excluded cases with EDSS data missing at two or more time points ( n = 25, 16 from AusLong).…”

Section: Methodsmentioning

confidence: 99%

“…2 The impact of MS on people’s lives is multifaceted, profoundly disrupting careers, relationships, families and health-related quality of life (HRQoL). 3 Transition probabilities are widely used in the assessment of disease progression between different levels of disease severities. 4–7 Transition probabilities are numbered between 0 and 1, where 0 = impossible and 1 = certain.…”

Section: Introductionmentioning

confidence: 99%

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Estimation of annual probabilities of changing disability levels in Australians with relapsing-remitting multiple sclerosis

et al. 2018

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Background: Transition probabilities are the engine within many health economics decision models. However, the probabilities of progression of disability due to multiple sclerosis (MS) have not previously been estimated in Australia. Objectives: To estimate annual probabilities of changing disability levels in Australians with relapsing-remitting MS (RRMS). Methods: Combining data from Ausimmune/Ausimmune Longitudinal (2003–2011) and Tasmanian MS Longitudinal (2002–2005) studies ( n = 330), annual transition probabilities were obtained between no/mild (Expanded Disability Status Scale (EDSS) levels 0–3.5), moderate (EDSS 4–6.0) and severe (EDSS 6.5–9.5) disability. Results: From no/mild disability, 6.4% (95% confidence interval (CI): 4.7–8.4) and 0.1% (0.0–0.2) progressed to moderate and severe disability annually, respectively. From moderate disability, 6.9% (1.0–11.4) improved (to no/mild state) and 2.6% (1.1–4.5) worsened. From severe disability, 0.0% improved to moderate and no/mild disability. Male sex, age at onset, longer disease duration, not using immunotherapies greater than 3 months and a history of relapse were related to higher probabilities of worsening. Conclusion: We have estimated probabilities of changing disability levels in Australians with RRMS. Probabilities differed between various subgroups, but due to small sample sizes, results should be interpreted with caution. Our findings will be helpful in predicting long-term disease outcomes and in health economic evaluations of MS.

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Health Impairment From Nasal Airway Obstruction and Changes in Health Utility Values From Septorhinoplasty

Tjahjono

Alvarado

Kalish

et al. 2019

JAMA Facial Plast Surg

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IMPORTANCEThe association of nasal airway obstruction with health is significant, and the health care resources utilized in open septorhinoplasty need to be included in health economic analyses.OBJECTIVES To describe the association of nasal airway obstruction and subsequent open septorhinoplasty with patient health. DESIGN, SETTING, AND PARTICIPANTSA prospective case series study was conducted from September 30, 2009, to October 29, 2015, at 2 tertiary rhinologic centers in Sydney, Australia, among 144 consecutive adult patients (age, Ն18 years) with nasal airway obstruction from septal and nasal valve disorders. INTERVENTIONS Open septorhinoplasty.MAIN OUTCOMES AND MEASURES Patients were assessed before undergoing open septorhinoplasty and then 6 months after the procedure. Health utility values (HUVs) were derived from the 36-Item Short Form Health Survey. Nasal obstruction severity was also measured using the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire and the Sino-Nasal Outcome Test 22 questionnaires.RESULTS A total of 144 patients (85 women and 59 men; mean [SD] age, 38 [13] years) were assessed. The baseline mean (SD) HUV for patients in this study was 0.72 (0.09), which was below the weighted mean (SD) Australian norm of 0.81 (0.22). After open septorhinoplasty, the mean (SD) HUV improved to 0.78 (0.12) (P < .001). Improvements in HUV were associated with changes in disease-specific patient-reported outcome measures, including Nasal Obstruction Symptom Evaluation scores (r = -0.48; P = .01) and Sino-Nasal Outcome Test 22 scores (r = −0.68; P = .01). CONCLUSIONS AND RELEVANCEPatients with nasal airway obstruction reported baseline HUVs that were lower than the Australian norm and similar to those in individuals with chronic diseases with significant health expenditure. There was a clinically and statistically significant improvement in HUVs after open septorhinoplasty that was associated with a reduction in Nasal Obstruction Symptom Evaluation and Sino-Nasal Outcome Test 22 scores. Outcomes from this study may be used for health economic analyses of the benefit associated with open septorhinoplasty.LEVEL OF EVIDENCE 4.

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The impact of multiple sclerosis severity on health state utility values: Evidence from Australia

Abstract: For the first time in Australia, we have quantified the impact of increasing severity of MS on health utility of people with MS. The HSUVs we have generated will be useful in further health economic analyses of interventions that slow progression of MS.

Cited by 29 publications

References 32 publications

Treatment satisfaction and quality of life in patients treated with fingolimod

Treatment satisfaction and quality of life in patients treated with fingolimod

Estimation of annual probabilities of changing disability levels in Australians with relapsing-remitting multiple sclerosis

Health Impairment From Nasal Airway Obstruction and Changes in Health Utility Values From Septorhinoplasty

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