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Elicitation of Health-Related Utility in Perianal Fistula in Crohn’s Disease

Author

Listed:
  • Louise Longworth

    (PHMR Limited)

  • Donna Fountain

    (PHMR Limited)

  • Jeshika Singh

    (PHMR Limited)

  • Ismail Azzabi

    (Takeda Pharmaceuticals International GmbH)

  • Glynn Owen

    (Takeda UK Ltd)

  • Ulf Lundstam

    (Gothenburg University)

  • Shaji Sebastian

    (Hull and East Yorkshire Hospital)

Abstract

Background and Objective Perianal fistulae are a common complication of Crohn’s disease (CD) and pose a substantial burden on quality of life. Data capturing health-related utility associated with perianal fistulae in CD are scarce. The current study aims to value health states related to different stages of the disease to quantitatively evaluate the impact of complex perianal fistulae on CD patients’ quality of life. Methods Eight health state descriptions associated with complex perianal fistulae in CD were developed following qualitative research with patients and validation by clinicians. Following pre-testing, a survey was administered online in two samples of UK respondents: the general population and patients with CD. A choice-based valuation technique, the time trade-off (TTO), was used for direct utility measurement. CD patients also valued their current health state using the TTO. Exclusion criteria for respondents displaying logical inconsistencies were applied. Results Usable responses were received from 835 respondents, reflective of the UK population in age and sex, in the general population survey and 162 CD patients in the patient survey. Non-remission states were valued much lower than the remission state by both samples, ranging from 0.20 for proctectomy with a negative outcome to 0.66 for chronic symptomatic fistulae with mild symptoms. Patients currently experiencing fistulae reported lower values for current health than those without fistulae. Conclusion Low utility values were assigned to the non-remission health states for perianal fistulae in CD by the general public and patients with CD. This demonstrates the high humanistic burden of inadequately managed perianal fistula in CD.

Suggested Citation

  • Louise Longworth & Donna Fountain & Jeshika Singh & Ismail Azzabi & Glynn Owen & Ulf Lundstam & Shaji Sebastian, 2019. "Elicitation of Health-Related Utility in Perianal Fistula in Crohn’s Disease," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(3), pages 339-348, June.
  • Handle: RePEc:spr:patien:v:12:y:2019:i:3:d:10.1007_s40271-018-0352-2
    DOI: 10.1007/s40271-018-0352-2
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    References listed on IDEAS

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    1. John Brazier & Aki Tsuchiya, 2010. "Preference‐based condition‐specific measures of health: what happens to cross programme comparability?," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 125-129, February.
    2. Nancy J. Devlin & Koonal K. Shah & Yan Feng & Brendan Mulhern & Ben van Hout, 2018. "Valuing health‐related quality of life: An EQ‐5D‐5L value set for England," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 7-22, January.
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