Sach Tracey H, Barton Garry R, Jenkinson Claire, Doherty Michael, Avery Anthony J, Muir Kenneth R
School of Chemical Sciences and Pharmacy, University of East Anglia, Norwich, NR4 7TJ United Kingdom.
Med Care. 2009 Aug;47(8):889-94. doi: 10.1097/MLR.0b013e3181a39428.
A number of different measures can be used within cost-utility analyses, we compared results according to both the EQ-5D and SF-6D.
A randomized trial was conducted to compare 4 options for people with knee pain. Over the 2 year trial period, the change in cost to health-service was estimated, and both the EQ-5D and SF-6D were used to estimate the change in quality-adjusted life years (QALYs). Using a complete case analysis, the cost-utility (incremental cost-effectiveness ratio [ICER]) of each option, according to both the EQ-5D and SF-6D, was calculated and assessed in relation to the cost-effectiveness threshold of pound20,000 per QALY.
Of the 389 participants, 247 had complete cost, EQ-5D and SF-6D data. According to the EQ-5D, option 1 had an estimated ICER of pound10,815 (compared with option 4), option 2 was dominated by option 1, and option 3 was subject to extended dominance. Conversely, according to the SF-6D, option 3 had an ICER of pound9999 (compared with option 4), option 2 had an ICER of pound36,883 (compared with option 3), and option 1 was subject to extended dominance.
The EQ-5D and SF-6D estimated that different options (1 and 3, respectively) were cost-effective at the pound20,000 per QALY threshold, demonstrating that the choice of measure does matter.
在成本效用分析中可以使用多种不同的测量方法,我们根据EQ - 5D和SF - 6D对结果进行了比较。
进行了一项随机试验,比较针对膝关节疼痛患者的4种选择。在为期2年的试验期内,估计了卫生服务成本的变化,并使用EQ - 5D和SF - 6D来估计质量调整生命年(QALY)的变化。采用完整病例分析,根据EQ - 5D和SF - 6D计算并评估了每种选择的成本效用(增量成本效益比[ICER]),并与每QALY 20,000英镑的成本效益阈值进行比较。
在389名参与者中,247人有完整的成本、EQ - 5D和SF - 6D数据。根据EQ - 5D,方案1的估计ICER为10,815英镑(与方案4相比),方案2被方案1所主导,方案3存在扩展主导情况。相反,根据SF - 6D,方案3的ICER为9999英镑(与方案4相比),方案2的ICER为36,883英镑(与方案3相比),方案1存在扩展主导情况。
EQ - 5D和SF - 6D估计不同的选择(分别为方案1和方案3)在每QALY 20,000英镑的阈值下具有成本效益,表明测量方法的选择确实很重要。