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Modelling EuroQol health‐related utility values for diabetic complications from CODE‐2 data

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  • Adrian Bagust
  • Sophie Beale

Abstract

Recent research has employed different analytical techniques to estimate the impact of the various long‐term complications of type 2 diabetes on health‐related utility and health status. However, limited patient numbers or lack of variety of patient experience has limited their power to discriminate between separate complications and grades of severity. In this study alternative statistical model forms were compared to investigate the influence of various factors on self‐assessed health status and calculated utility scores, including the presence and severity of complications, and type of diabetes therapy. Responses to the EuroQol EQ‐5D questionnaire from 4641 patients with type 2 diabetes in 5 European countries were analysed. Simple multiple regression analysis was used to model both visual analogue scale (VAS) scores and time trade‐off index scores (TTO). Also, two complex models were developed for TTO analysis using a structure suggested by the EuroQol calculation algorithm. Both VAS and TTO models achieved greater explanatory power than in earlier studies. Relative weightings for individual complications differed between VAS and TTO scales, reflecting the strong influence of loss of mobility and severe pain in the EuroQol algorithm. Insulin‐based therapy was uniformly associated with a detrimental effect equivalent to an additional moderate complication. Evidence was found that TTO values are not responsive in cases where 3 or more multiple complications are present, and therefore may underestimate utility loss for patients most adversely affected by complex chronic diseases like diabetes. Copyright © 2004 John Wiley & Sons, Ltd.

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  • Adrian Bagust & Sophie Beale, 2005. "Modelling EuroQol health‐related utility values for diabetic complications from CODE‐2 data," Health Economics, John Wiley & Sons, Ltd., vol. 14(3), pages 217-230, March.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:3:p:217-230
    DOI: 10.1002/hec.910
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    5. Gemma Shields & Stephen Beard, 2015. "A Systematic Review of the Economic and Humanistic Burden of Gout," PharmacoEconomics, Springer, vol. 33(10), pages 1029-1047, October.
    6. Melanie J. Davies & Divina Glah & Barrie Chubb & Gerasimos Konidaris & Phil McEwan, 2016. "Cost Effectiveness of IDegLira vs. Alternative Basal Insulin Intensification Therapies in Patients with Type 2 Diabetes Mellitus Uncontrolled on Basal Insulin in a UK Setting," PharmacoEconomics, Springer, vol. 34(9), pages 953-966, September.
    7. Alison J. Hayes & Philip M. Clarke & Merryn Voysey & Anthony Keech, 2011. "Simulation of Quality-Adjusted Survival in Chronic Diseases," Medical Decision Making, , vol. 31(4), pages 559-570, July.
    8. Richard F. Pollock & William J. Valentine & Steven P. Marso & Andreas Andersen & Jens Gundgaard & Nino Hallén & Deniz Tutkunkardas & Elizabeth A. Magnuson & John B. Buse, 2019. "Long-term Cost-effectiveness of Insulin Degludec Versus Insulin Glargine U100 in the UK: Evidence from the Basal-bolus Subgroup of the DEVOTE Trial (DEVOTE 16)," Applied Health Economics and Health Policy, Springer, vol. 17(5), pages 615-627, October.
    9. Michael Willis & Adam Fridhammar & Jens Gundgaard & Andreas Nilsson & Pierre Johansen, 2020. "Comparing the Cohort and Micro-Simulation Modeling Approaches in Cost-Effectiveness Modeling of Type 2 Diabetes Mellitus: A Case Study of the IHE Diabetes Cohort Model and the Economics and Health Out," PharmacoEconomics, Springer, vol. 38(9), pages 953-969, September.
    10. Åsa Ericsson & Divina Glah & Maria Lorenzi & Jeroen P Jansen & Adam Fridhammar, 2018. "Cost-effectiveness of liraglutide versus lixisenatide as add-on therapies to basal insulin in type 2 diabetes," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-16, February.
    11. Scott Doyle & Andrew Lloyd & Lee Moore & Joshua Ray & Alastair Gray, 2012. "A Systematic Review and Critical Assessment of Health State Utilities," PharmacoEconomics, Springer, vol. 30(12), pages 1133-1143, December.
    12. Maria Alva & Alastair Gray & Borislava Mihaylova & Philip Clarke, 2014. "The Effect Of Diabetes Complications On Health‐Related Quality Of Life: The Importance Of Longitudinal Data To Address Patient Heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 487-500, April.
    13. Phil McEwan & Jason Gordon & Marc Evans & Thomas Ward & Hayley Bennett & Klas Bergenheim, 2015. "Estimating Cost-Effectiveness in Type 2 Diabetes," Medical Decision Making, , vol. 35(5), pages 660-670, July.
    14. Pierre Johansen & Jonas Håkan-Bloch & Aiden R. Liu & Peter G. Bech & Sofie Persson & Lawrence A. Leiter, 2019. "Cost Effectiveness of Once-Weekly Semaglutide Versus Once-Weekly Dulaglutide in the Treatment of Type 2 Diabetes in Canada," PharmacoEconomics - Open, Springer, vol. 3(4), pages 537-550, December.
    15. Åsa Ericsson & Adam Lundqvist, 2017. "Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden," Applied Health Economics and Health Policy, Springer, vol. 15(2), pages 237-248, April.
    16. Chen-Wei Pan & Hong-Peng Sun & Hui-Jun Zhou & Qinghua Ma & Yong Xu & Nan Luo & Pei Wang, 2016. "Valuing Health-Related Quality of Life in Type 2 Diabetes Patients in China," Medical Decision Making, , vol. 36(2), pages 234-241, February.
    17. Hui Shao & Shuang Yang & Vivian Fonseca & Charles Stoecker & Lizheng Shi, 2019. "Estimating Quality of Life Decrements Due to Diabetes Complications in the United States: The Health Utility Index (HUI) Diabetes Complication Equation," PharmacoEconomics, Springer, vol. 37(7), pages 921-929, July.

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