Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1b St., 02-097, Warsaw, Poland.
HealthQuest Spółka z ograniczoną odpowiedzialnością Sp. k., 63 Mickiewicza Street, Megadex A Building, 01-625, Warsaw, Poland.
Pharmacoeconomics. 2019 Sep;37(9):1165-1176. doi: 10.1007/s40273-019-00811-7.
Cost-utility analyses are becoming increasingly important in Central and Eastern Europe. We aimed to develop a Polish utility tariff for EQ-5D-5L health states.
Face-to-face, computer-assisted interviews were collected in a representative sample. Each respondent followed a standardised protocol to collect ten composite time trade-off and seven discrete choice experiment observations. In the Bayesian approach, several model specifications were compared based on model fit, the usability of the final value set and how they reflect the elicitation procedure (e.g. censoring). A hybrid approach (using composite time trade-off and discrete choice experiment data) was employed in the final set, which was compared with the existing ones: EQ-5D-3L and EQ-5D-5L cross-walk.
Data from 1252 respondents (11,480 composite time trade-off valuations and 8764 discrete choice experiment pairs) were collected over the period June to October 2016. The final model accounted for random parameters, error scaling with fat tails, censoring at - 1, unwillingness to trade in time trade-off by the religious people and Cauchy distribution in discrete choice experiments. Pain/discomfort impacts the utility most: the disutility equals 0.575 when at level 5. In the value set, 4.4% of EQ-5D-5L states are worse than dead. The new value set has a comparable range (minimum of - 0.590 compared to - 0.523) and the same ordering of the first three dimensions (pain/discomfort, mobility, self-care) as the EQ-5D-3L value set and the EQ-5D-5L cross-walk value set. Moreover, it is more sensitive to a moderate decline in health.
The new value set supports consistency with past decisions in cost-utility studies, while offering a better assessment of even moderate improvements in health. It could represent an option for Central and Eastern Europe countries lacking their own value sets.
成本效用分析在中东欧变得越来越重要。我们旨在为 EQ-5D-5L 健康状况制定波兰效用关税。
在代表性样本中进行面对面、计算机辅助访谈。每位受访者都遵循标准化协议，收集十个复合时间权衡和七个离散选择实验观察结果。在贝叶斯方法中，根据模型拟合、最终值集的可用性以及它们如何反映启发式程序（例如屏蔽）比较了几种模型规格。混合方法（使用复合时间权衡和离散选择实验数据）用于最终集，并与现有的 EQ-5D-3L 和 EQ-5D-5L 交叉进行比较。
2016 年 6 月至 10 月期间共收集了 1252 名受访者的数据（11480 个复合时间权衡估值和 8764 个离散选择实验对）。最终模型考虑了随机参数、具有长尾误差缩放、在-1 处屏蔽、宗教人士不愿意进行时间权衡以及离散选择实验中的柯西分布。疼痛/不适对效用的影响最大：当处于第 5 级时，不愉悦值为 0.575。在价值集中，4.4%的 EQ-5D-5L 状态比死亡更差。新的价值集具有可比的范围（最小值为-0.590，与 EQ-5D-3L 价值集和 EQ-5D-5L 交叉值集的-0.523 相同），并且前三个维度（疼痛/不适、移动性、自理）的顺序相同。此外，它对健康的适度下降更为敏感。
新的价值集支持成本效用研究中过去决策的一致性，同时提供了对健康状况甚至适度改善的更好评估。对于缺乏自己的价值集的中东欧国家来说，它可能是一种选择。
