A Review of Generic Preference-Based Measures for Use in Cost-Effectiveness Models

Abstract

Generic preference-based measures (GPBMs) of health are used to obtain the quality adjustment weight required to calculate the quality-adjusted life year in health economic models. GPBMs have been developed to use across different interventions and medical conditions and typically consist of a self-complete patient questionnaire, a health state classification system, and preference weights for all states defined by the classification system. Of the six main GPBMs, the three most frequently used are the Health Utilities Index version 3, the EuroQol 5 dimensions (3 and 5 levels), and the Short Form 6 dimensions. There are considerable differences in GPBMs in terms of the content and size of descriptive systems (i.e. the numbers of dimensions of health and levels of severity within these), the methods of valuation [e.g. time trade-off (TTO), standard gamble (SG)], and the populations (e.g. general population, patients) used to value the health states within the descriptive systems. Although GPBMs are anchored at 1 (full health) and 0 (dead), they produce different health state utility values when completed by the same patient. Considerations when selecting a measure for use in a clinical trial include practicality, reliability, validity and responsiveness. Requirements of reimbursement agencies may impose additional restrictions on suitable measures for use in economic evaluations, such as the valuation technique (TTO, SG) or the source of values (general public vs. patients).

Incorporating Quantitative Patient Preference Data into Healthcare Decision Making Processes: Is HTA Falling Behind?

“…A common example of the latter is health state valuation, using exercises such as time trade-off or standard gamble [5]. These exercises enable researchers to create value sets for multi-attribute utility instruments (MAUIs), such as the EuroQol Group's EQ-5D [6], that are routinely applied in health technology assessments (HTAs) that use cost-utility analyses (CUAs) where the quality-adjusted life year (QALY) is the measure of benefit [7,8].…”

An Educational Review About Using Cost Data for the Purpose of Cost-Effectiveness Analysis

“…Instruments for person-reported cost measurement have been developed, with the Client Service Receipt Inventory (CSRI) the most commonly used example [31], however it has been adapted/modified many times (estimated to be over 200) and is therefore neither fully standardised nor universally applicable [32]. Standardising instruments may be considered useful for cross-study comparisons, allowing for easier comparison across CEAs, which could be perceived as similar to the debate around using generic outcome measures for CEA [33,34] and the EQ-5D as the NICE reference case [2,35]; the counter to which could also be perceived as similar to those rationalisations for using condition-specific measures for outcome measurement [36]-that there are specific aspects of resource use and costs that are important in certain, but not all, decision problems. As such, standardised resource-use measurement instruments may not be specific enough to capture all important resources for particular decision problems.…”

A conceptual map of health-related quality of life dimensions: key lessons for a new instrument

“…Second, whether their scoring system, or value sets, are based on individuals' preferences. The sub-group of instruments that are both generic and preference based are referred to as generic preference-based measures (GPBM) [1]; health state utility (HSU) instruments [2], or; Multi Attribute Utility Instruments (MAUI) [3]. Given that these instruments are developed for the purpose of valuing health states, we opt for the most telling acronym HSU in the current paper.…”