Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research

OBJECTIVE: Several measures have been used or developed to capture the health and well-being of caregivers, including the EQ Health and Well-being (EQ-HWB) and its short form, EQ-HWB-S. This study aimed to evaluate the psychometric properties and construct validity of the EQ-HWB/EQ-HWB-S in a US caregiver population. METHODS: A cross-sectional survey was conducted involving 504 caregivers. Eligible participants were 18+ years old, provided unpaid care to a relative/friend aged 18+ in the past six months, and spent on average of at least one hour per week caregiving...

OBJECTIVES: Pelvic organ prolapse is the descent of one or more reproductive organs from their normal position, causing associated negative symptoms. One conservative treatment option is pessary management. The aim of this study was to investigate the cost-effectiveness of pessary self-management (SM) when compared to clinic-based care (CBC). A decision-analytic model was developed to extend the economic evaluation. METHODS: A randomised controlled trial with health economic evaluation...

OBJECTIVE: In 2018, Rwanda launched a national program to eliminate the hepatitis C virus (HCV). We aim to assess the impact of the program to date and identify strategies to achieve the World Health Organization's HCV elimination goals by 2030. METHODS: We developed a microsimulation model to simulate Rwanda's HCV epidemic from 2015 through 2050 and evaluated temporal trends in HCV infection, prevalence, mortality, and the total cost of care for scenarios that could achieve HCV elimination by 2030...

OBJECTIVES: The EQ Health and Wellbeing, EQ-HWB (25-item) and the EQ-HWB-S (9-item), are new generic measures of health and wellbeing. The purpose of this study was to examine the measurement properties of the EQ-HWB and EQ-HWB-S measures in relation to the EQ-5D-5L among the Italian general population. METHODS: A cross-sectional survey was conducted from October 2020 to February 2021, followed by secondary analysis of collected data from Italian adults. This analysis included response pattern distributions, correlation strength, and known group comparison (KGC)...

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OBJECTIVES: Time trade-off (TTO) and discrete choice experiment (DCE) preference-elicitation techniques can be administered using face-to-face interviews (F2F), unassisted online (UO) surveys, or remote-assisted (RA) interviews. The objective of this study was to explore how the mode of administration affects the quality and reliability of preference-elicitation data. METHODS: EQ-5D-5L health states were valued using composite TTO (cTTO) and DCE approaches by the UK general population...

OBJECTIVES: The EQ-5D-Y-5L is a generic preference-based measure of health-related quality of life (HRQoL) for children. This study aimed to describe the distributional properties, test-retest reliability, and convergent validity of the EQ-5D-Y-5L in children with intellectual disability (ID). METHODS: Caregivers of children with ID (aged 4 to 18 years) completed an online survey including a proxy-report EQ-5D-Y-5L, the Quality of life Inventory-Disability (QI-Disability), and disability-appropriate measures corresponding to the EQ-5D dimensions: mobility (MO), self-care (SC), usual activities (UA), pain/discomfort (PD), and worry/sadness/unhappiness (WSU)...

OBJECTIVES: This review aims to examine the ceiling effects of EQ-5D-3L (3L) and EQ-5D-5L (5L) in general adult populations and identify the factors influencing these effects. METHODS: We searched eight databases for observational studies published in English from inception to 24 July 2023. Ceiling effects were calculated by dividing the number of participants reporting full health at dimension or profile level by the total sample size. Subgroup analysis and meta-regression using the metafor package in R software were performed...

OBJECTIVES: This study assesses the impact of expanding pneumococcal vaccination to all 50-year-olds to decrease racial disparities by estimating from the societal perspective, the cost-effectiveness of 20-valent pneumococcal conjugate vaccine (PCV20) and 15-valent conjugate vaccine followed by 23-valent polysaccharide vaccine (PCV15/PPSV23) for 50-year-olds. METHODS: A Markov model compared the cost-effectiveness of PCV20 or PCV15/PPSV23 in all general population 50- and 65-years-olds compared to current US recommendations and to no vaccination in US Black and non-Black cohorts...

OBJECTIVES: Health technology assessment (HTA) guidance often recommends a 3 percent real annual discount rate, the appropriateness of which has received limited attention. This paper seeks to identify an appropriate rate for high-income countries because it can influence projected cost-effectiveness and hence resource allocation recommendations. METHODS: The author conducted two Pubmed.gov searches. The first sought articles on the theory for selecting a rate. The second sought HTA guidance documents...

OBJECTIVE: The environmental impacts of healthcare are an important factor that should be considered during health technology assessments. This study aims to summarise the evidence that exists about methods to include environmental impacts in health economic evaluations and health technology assessments. METHODS: We identified records for screening using an existing scoping review and a systematic search of academic databases and grey literature up to September 2023...

OBJECTIVES: To improve access, the VA MISSION Act of 2018 mandated a two-year study of medical scribes in Veterans Health Administration specialty clinics and emergency departments. Medical scribes are employed in clinical settings with the goals of increasing provider productivity and satisfaction by minimizing physicians' documentation burden. Our objective is to quantify the economic outcomes of the MISSION ACT scribes trial. METHODS: A cluster randomized trial was designed with 12 VA Medical Centers randomized into the intervention...

OBJECTIVES: This manuscript examines the inclusion of patient-reported outcome (PRO) data in new drug applications (NDAs) submitted to the Food and Drug Administration (FDA) and approved from 2018 through 2021. The importance of assessing PROs, which capture patients' perspectives on the disease and treatment experience, has been underscored by many stakeholders, including regulatory authorities. Despite the increasing inclusion of PRO assessments in registration trials, inclusion of language related to PRO results in approved product labeling varies widely...

OBJECTIVES: Economic evaluations using broader measures to capture benefits beyond improved health can inform policy-making, but only if the monetary value of gains measured using these instruments is understood. This study explored contingent valuation as a method to estimate the monetary value of a wellbeing-adjusted life year (WALY) as measured by ICECAP-A. METHODS: In a large online survey of representative samples from seven European countries, participants valued a change in the ICECAP-A from their current health state to a randomly assigned hypothetical state...

OBJECTIVE: To understand the psychometric properties of EQ Health and Wellbeing (EQ-HWB) and to examine its relationship with EQ-5D-5L in a sample covering patients, carers, and general public. METHODS: A cross-sectional study was conducted in Guizhou Province, China. The acceptability, convergent validity (using Spearman correlation coefficients), internal structure (using Exploratory Factor Analysis, EFA), and known-group validity of EQ-HWB, EQ-HWB-Short (EQ-HWB-S), and EQ-5D-5L were reported and compared...

OBJECTIVE: To evaluate the impact of NICE's new severity modifier, which has replaced the end-of-life (EoL) premium, on future NICE recommendations, considering past decision-making patterns. METHODS: NICE technology appraisals (TAs) published between January 2020 and December 2022 were reviewed. Summary statistics were generated to assess how the new severity modifier might impact hypothetical decision-making in historical TAs. RESULTS: A total of 138 data points were identified from 132 TAs...

OBJECTIVES: Economic evaluations of interventions in health and social care require outcome measures that capture their full benefits, including those beyond health. The aim of this study was to assess construct validity, test-retest reliability, and responsiveness of the newly developed 10-item Well-being instrument (WiX). METHODS: Data was gathered via an online survey in a representative sample of the adult general population in the Netherlands (N=1,045). Construct validity was assessed by inspecting convergent, structural and discriminant validity, following the COSMIN methodology...

OBJECTIVES: To determine the accuracy and consistency of established methods of extrapolating mean survival for immuno-oncology (IO) therapies, the extent of any systematic biases in estimating long-term clinical benefit, what influences the magnitude of any bias, and the potential implications for health technology assessment (HTA). METHODS: A targeted literature search was conducted to identify published long-term follow-up from clinical trials of immune checkpoint inhibitors...

OBJECTIVE: To investigate the relative importance of key life domains of early adolescents and to explore the heterogeneities across age cohorts and countries at different levels of economic development. METHODS: The repeated cross-sectional survey data for 10 countries (England, Israel, Romania, Norway, Malta, Nepal, Estonia, Ethiopia, South Korea and Germany) from the second (2013-2014) and third (2016-2019) waves of the International Survey of Children's Well-being study were used...

A wide range of methods are available for generating health preference information. Choosing an adequate method when designing a study is important for ensuring robust results and fit-for-purpose outputs. While multiple methods overviews have been developed for commonly used preference elicitation instruments, such as discrete choice experiments, information on the principles underlying the design and analysis of novel methods is often limited. This manuscript provides the first introduction into the design and analysis of multidimensional thresholding (MDT)...