Zhou Junwen, Millier Aurélie, François Clément, Aballéa Samuel, Toumi Mondher
Public Health Department, Aix-Marseille University, Marseille, France.
Health Economic and Outcome Research Department, Creativ-Ceutical, Paris, France.
J Mark Access Health Policy. 2019 Aug 22;7(1):1648973. doi: 10.1080/20016689.2019.1648973. eCollection 2019.
: Utility elicitation studies for schizophrenia generate different utility values for the same health states. We reviewed utility values used in schizophrenia pharmacoeconomic evaluations and evaluated the impact of their selection on the incremental cost-effectiveness ratio (ICER). : A systematic search was performed in Medline and Embase. Health state definitions, associated utility values, elicitation studies, and value selection processes were extracted. Sets of utility values for all schizophrenia health states were used in a cost-effectiveness model to evaluate the ICER. : Thirty-five cost-utility analyses (CUAs) referring to 11 utility elicitation studies were included. The most frequent health states were 'stable' (28 CUAs, 7 utility elicitation studies, 10 values, value range 0.650-0.919), 'relapse requiring hospitalisation' (18, 5, 7, 0.270-0.604), 'relapse not requiring hospitalisation' (18, 5, 10, 0.460-0.762), and 'relapse only' (10, 5, 6, 0.498-0.700). Seventeen sets of utility values were identified with difference in utility values between relapse and stable ranging from -0.358 to -0.050, resulting in ICERs ranging from -56.2% to +222.6% from average. : The use of utility values for schizophrenia health states differs among CUAs and impacts on the ICER. More rigorous and transparent use of utility values and sensitivity analysis with different sets of utility values are suggested for future CUAs.
针对精神分裂症的效用诱导研究针对相同的健康状态产生了不同的效用值。我们回顾了精神分裂症药物经济学评估中使用的效用值，并评估了其选择对增量成本效益比（ICER）的影响。：在Medline和Embase中进行了系统检索。提取了健康状态定义、相关效用值、诱导研究和值选择过程。在成本效益模型中使用所有精神分裂症健康状态的效用值集来评估ICER。：纳入了35项成本效用分析（CUA），涉及11项效用诱导研究。最常见的健康状态是“稳定”（28项CUA、7项效用诱导研究、10个值，值范围为0.650 - 0.919）、“需要住院治疗的复发”（18项、5项、7项、0.270 - 0.604）、“不需要住院治疗的复发”（18项、5项、10项、0.460 - 0.762）和“仅复发”（10项、5项、6项、0.498 - 0.700）。确定了17组效用值，复发与稳定状态之间效用值的差异范围为 - 0.358至 - 0.050，导致ICER平均范围为 - 56.2%至 + 222.6%。：CUA之间用于精神分裂症健康状态的效用值使用情况不同，且对ICER有影响。建议未来的CUA更严格、透明地使用效用值，并对不同的效用值集进行敏感性分析。
