THE CONSISTENCY IN USING HEALTH UTILITIES BETWEEN COST-UTILITY ANALYSES IN ONCOLOGY AND REFERRED ORIGINAL HEALTH UTILITY STUDIES: A REGISTRY-BASED REVIEW

Abstract

Background: Cancer is a big threat to human health and imposes a heavy financial burden on health care systems worldwide. Cost-utility analyses (CUAs) have been widely used to measure cost-effectiveness of new cancer treatments. In a CUA, health utilities (HUs) are used to calculate quality-adjusted life years (QALYs) and thus play an important role in determining cost-effectiveness results.

Methods: Oncology CUAs that were included in the Cost-Effectiveness Analysis (CEA) Registry of the Center for the Evaluation of Value and Risk in Health (CEVR), published in English through 2016 and reported HUs and QALYs were identified and included in the study. Data were collected from the oncology CUAs and referenced original HU studies. The consistency of HUs were assessed by comparing both health state descriptions and utility values between the oncology CUAs and corresponding original HU studies.

Results: In total, 912 out of 1062 CUAs that investigated cancer diseases from the CEVR CEA Registry and 5583 HUs used in them were included in the analysis. 1353 HUs (24.2%) were measured along with the CUAs (defined as primary data) and 4230 HUs (75.8%) were derived from other sources (defined as secondary data). Out of the 3360 HUs for which the original studies were identified and compared with the CUAs, 1348 (40.1%) had the same health state descriptions and utility values, 633 (18.9%) differed only in value, 390 (11.6%) differed only in description, and 989 (29.4%) differed in both description and value. Among the 2012 HUs had either or both descriptions and utility values different from original HU studies, 377 (18.7%) of them were used without explanation, and 143 (7.1%) were derived from different diseases.

Conclusions: Our study found there were discrepancies in using published health utilities in oncology CUAs. Consistent use of health utilities needs to be improved.