EQ-5D-5L utilities per health states in Spanish population with knee or hip osteoarthritis

Abstract

BackgroundThe objective of this study was to obtain utilities by means of EQ-5D-5L for different health states in patients with knee osteoarthritis (KOA) or hip osteoarthritis (HOA) in Spain, and to compare these values with those used in foreign studies with the aim of discussing their transferability for their use in economic evaluations conducted in Spain.MethodsPrimary study: Observational prospective study of KOA or HOA patients in Spain. Sociodemographic and clinical characteristics were collected to characterize the sample. Utilities were elicited using the EQ-5D-5L questionnaire. ANOVA and bivariable analyses were conducted to identify differences between health states. Literature review: Using the bibliographic databases NSH EED and CEA Registry, we conducted searches of model-based cost utilities analyses of technologies in KOA or HOA patients. Health states and utilities were extracted and compared with values obtained from the Spanish sample.ResultsThree hundred ninety-seven subjects with KOA and 361 subjects with HOA were included, with average utilities of 0.544 and 0.520, respectively. In both samples, differences were found in utilities according to level of pain, stiffness and physical function (WOMAC) and severity of symptoms (Oxford scales), so that the worst the symptoms, the lower the utilities. The utilities after surgery were higher than before surgery. Due to limitations from our study related to sample size and observational design, it was not possible to estimate utilities for approximately half the health states included in the published models because they were directly related to specific technologies. For almost 100% of health states of the selected studies we obtained very different utilities from those reported in the literature.ConclusionsTo our knowledge this is the first article with detailed utilities estimated using the EQ-5D-5L in Spain for KOA and HOA patients. In both populations, utilities are lower for worse health states in terms of level of pain, stiffness and physical function according to WOMAC, and according to the Oxford scales. Most utilities obtained from the Spanish sample are lower than those reported in the international literature. Further studies estimating utilities from local populations are required to avoid the use of foreign sources in economic evaluations.

Cost-Effectiveness Analysis of the Treatment Strategies with or without Opioid Medications in Surgery-Eligible Patients with Osteoarthritis in Japan

“…No disutility due to AEs was applied in the model as this is already accounted for by the utility value of the health state [ 33 ]. Furthermore, discontinuation due to AEs was not considered in the model.…”

“…No relevant utility data was identified in the targeted literature review for a Japanese population with OA, although a patient-reported outcome study using the EQ-5D-5L questionnaire was identified that reported the utility values of the included health states for a Spanish population [ 33 ]. These values accounted for the baseline utility of the disease (OA of the knee or hip), the treatment (non-opioid, opioid, surgery and post-surgery), and the disutility due to the treatment (AEs) (Table 4 ).…”

“…For the opioid treatment, two categories of utility values were identified as potentially relevant: opiate derivatives (0.538 and 0.498 for knee and hip, respectively) and opioid pain medication (0.333 and 0.435 for knee and hip, respectively). However, because of the small number of patients in the opioid pain medication group, the utility values of the opiate derivatives were used in the model for the opioid health state [ 33 ]. For knee and hip surgery, the utility was assumed to be the average of that associated with waiting for the prosthetic implant and rehabilitation/physiotherapy because there is no exact utility value.…”

“…Given the example, the utility value of knee surgery was derived from the average of that associated with waiting for the prosthetic implant and rehabilitation/physiotherapy (0.120 = [0.100 + 0.139]/2, Table 4 ). The utility value of post-surgery was assumed to be equivalent to the utility value corresponding to prosthetic implant in the previous 6 months [ 33 ].…”

Impact of lower limb osteoarthritis on health-related quality of life: A cross-sectional study to estimate the expressed loss of utility in the Spanish population

“…The EQ-5D-5L is a generic instrument designed to measure dimensions of health relevant to all health states, including healthy individuals, and not patients' perception of aspects of health specifically affected by OALL. However, it has the advantage of allowing us to attribute patients' preferences to the described health status in patients with OALL and to compare them between different populations [48].…”