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Estimating QALY Gains in Applied Studies: A Review of Cost-Utility Analyses Published in 2010

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  • Torbjørn Wisløff
  • Gunhild Hagen
  • Vida Hamidi
  • Espen Movik
  • Marianne Klemp
  • Jan Olsen

Abstract

Reimbursement agencies in several countries now require health outcomes to be measured in terms of quality-adjusted life-years (QALYs), leading to an immense increase in publications reporting QALY gains. However, there is a growing concern that the various ‘multi-attribute utility’ (MAU) instruments designed to measure the Q in the QALY yield disparate values, implying that results from different instruments are incommensurable. By reviewing cost-utility analyses published in 2010, we aim to contribute to improved knowledge on how QALYs are currently calculated in applied analyses; how transparently QALY measurement is presented; and how large the expected incremental QALY gains are. We searched Embase, MEDLINE and NHS EED for all cost-utility analyses published in 2010. All analyses that had estimated QALYs gained from health interventions were included. Of the 370 studies included in this review, 48 % were pharmacoeconomic evaluations. Active comparators were used in 71 % of studies. The median incremental QALY gain was 0.06, which translates to 3 weeks in best imaginable health. The EQ-5D-3L is the dominant instrument used. However, reporting of how QALY gains are estimated is generally inadequate. In 55 % of the studies there was no reference to which MAU instrument or direct valuation method QALY data came from. The methods used for estimating expected QALY gains are not transparently reported in published papers. Given the wide variation in utility scores that different methodologies may assign to an identical health state, it is important for journal editors to require a more transparent way of reporting the estimation of incremental QALY gains. Copyright The Author(s) 2014

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  • Torbjørn Wisløff & Gunhild Hagen & Vida Hamidi & Espen Movik & Marianne Klemp & Jan Olsen, 2014. "Estimating QALY Gains in Applied Studies: A Review of Cost-Utility Analyses Published in 2010," PharmacoEconomics, Springer, vol. 32(4), pages 367-375, April.
    • Handle: RePEc:spr:pharme:v:32:y:2014:i:4:p:367-375
    DOI: 10.1007/s40273-014-0136-z
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    2. Lancsar, Emily & Gu, Yuanyuan & Gyrd-Hansen, Dorte & Butler, Jim & Ratcliffe, Julie & Bulfone, Liliana & Donaldson, Cam, 2020. "The relative value of different QALY types," Journal of Health Economics, Elsevier, vol. 70(C).
    3. Torbjørn Wisløff & Gunhild Hagen & Marianne Klemp, 2014. "Economic Evaluation of Warfarin, Dabigatran, Rivaroxaban, and Apixaban for Stroke Prevention in Atrial Fibrillation," PharmacoEconomics, Springer, vol. 32(6), pages 601-612, June.
    4. Hansen, Lise Desireé & Kjær, Trine, 2019. "Disentangling public preferences for health gains at end-of-life: Further evidence of no support of an end-of-life premium," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.
    5. Jan Abel Olsen & Admassu N. Lamu & John Cairns, 2018. "In search of a common currency: A comparison of seven EQ‐5D‐5L value sets," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 39-49, January.
    6. Myles-Jay Linton & Paul Mark Mitchell & Hareth Al-Janabi & Michael Schlander & Jeff Richardson & Angelo Iezzi & Jasper Ubels & Joanna Coast, 2020. "Comparing the German Translation of the ICECAP-A Capability Wellbeing Measure to the Original English Version: Psychometric Properties across Healthy Samples and Seven Health Condition Groups," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 15(3), pages 651-673, July.
    7. Tonya Moen Hansen & Knut Stavem & Kim Rand, 2023. "Completing the time trade-off with respondents who are older, in poorer health or with an immigrant background in an EQ-5D-5L valuation study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(6), pages 877-884, August.
    8. S. A. Lipman & V. T. Reckers-Droog & M. Karimi & M. Jakubczyk & A. E. Attema, 2021. "Self vs. other, child vs. adult. An experimental comparison of valuation perspectives for valuation of EQ-5D-Y-3L health states," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(9), pages 1507-1518, December.
    9. Magnus Zingmark & Ingeborg Nilsson & Fredrik Norström & Klas Göran Sahlén & Lars Lindholm, 2017. "Cost effectiveness of an intervention focused on reducing bathing disability," European Journal of Ageing, Springer, vol. 14(3), pages 233-241, September.
    10. Polly Mitchell & Anna Alexandrova, 2021. "Well-Being and Pluralism," Journal of Happiness Studies, Springer, vol. 22(6), pages 2411-2433, August.
    11. Magnus Zingmark & Fredrik Norström & Lars Lindholm & Synneve Dahlin-Ivanoff & Susanne Gustafsson, 2019. "Modelling long-term cost-effectiveness of health promotion for community-dwelling older people," European Journal of Ageing, Springer, vol. 16(4), pages 395-404, December.
    12. Paul Mark Mitchell & Samantha Husbands & Sarah Byford & Philip Kinghorn & Cara Bailey & Tim J. Peters & Joanna Coast, 2021. "Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 1990-2003, September.
    13. Vivian Reckers-Droog & Maartje Goorden & Yifrah Kaminer & Lieke van Domburgh & Werner Brouwer & Leona Hakkaart-van Roijen, 2020. "Presentation and validation of the Abbreviated Self Completion Teen-Addiction Severity Index (ASC T-ASI): A preference-based measure for use in health-economic evaluations," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-12, September.
    14. P. Wang & M. Li & G. Liu & J. Thumboo & N. Luo, 2015. "Do Chinese have similar health-state preferences? A comparison of mainland Chinese and Singaporean Chinese," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(8), pages 857-863, November.

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