Using the EQ-5D-5L to investigate quality-of-life impacts of disease-modifying therapy policies for people with multiple sclerosis (MS) in New Zealand
-
Published:2022-09-23
Issue:
Volume:
Page:
-
ISSN:1618-7598
-
Container-title:The European Journal of Health Economics
-
language:en
-
Short-container-title:Eur J Health Econ
Author:
Claflin Suzi, Campbell Julie A.ORCID, Norman Richard, Mason Deborah F., Kalincik Tomas, Simpson-Yap Steve, Butzkueven Helmut, Carroll William M., Palmer Andrew J., Blizzard C. Leigh, van der Mei Ingrid, Henson Glen J., Taylor Bruce V.
Abstract
Abstract
Background
Health state utilities (HSU) are a health-related quality-of-life (HRQoL) input for cost-utility analyses used for resource allocation decisions, including medication reimbursement. New Zealand (NZ) guidelines recommend the EQ-5D instruments; however, the EQ-5D-5L may not sufficiently capture psychosocial health. We evaluated HRQoL among people with multiple sclerosis (MS) in NZ using the EQ-5D-5L and assessed the instrument’s discriminatory sensitivity for a NZ MS cohort.
Methods
Participants were recruited from the NZ MS Prevalence Study. Participants self-completed a 45-min online survey that included the EQ-5D-5L/EQ-VAS. Disability severity was classified using the Expanded Disability Status Scale (EDSS) to categorise participant disability as mild (EDSS: 0–3.5), moderate (EDSS: 4.0–6.0) and severe (EDSS: 6.5–9.5). Anxiety/depression were also measured using the Hospital Anxiety and Depression Score (HADS). In the absence of an EQ-5D-5L NZ tariff, HSUs were derived using an Australian tariff. We evaluated associations between HSUs and participant characteristics with linear regression models.
Results
254 participants entered the study. Mean age was 55.2 years, 79.5% were female. Mean (SD) EQ-5D-5L HSU was 0.58 (0.33). Mean (SD) HSUs for disability categories were: mild 0.80 ± 0.17, moderate 0.57 ± 0.21 and severe 0.14 ± 0.32. Twelve percent reported HSU = 1.0 (i.e., no problems in any domain). Participants who had never used a disease-modifying therapy reported a lower mean HSU. Multivariable modelling found that the HADS anxiety score was not associated with EQ-5D-5L.
Conclusions
HRQoL for people with MS in NZ was lower than comparable countries, including Australia. We suggest a comparison with other generic tools that may have improved sensitivity to mental health.
Funder
University of Tasmania
Publisher
Springer Science and Business Media LLC
Subject
Health Policy,Economics, Econometrics and Finance (miscellaneous)
Reference42 articles.
1. Campbell, J.A., Weiland, T.J., Nag, N., Neate, S.L., Palmer, A.J., Mulhern, B., De Livera, A., Simpson-Yap, S.: SF-6D health state utilities for lifestyle, socio-demographic and clinical characteristics of a large international cohort of people with multiple sclerosis. Qual. Life Res. 29(9), 2509–2527 (2020) 2. Zhang, Y.T.B., Simpson, S., Blizzard, L., Campbell, J.A., Palmer, A.J., van der Mei, I.: Feelings of depression, pain and walking difficulties have the largest impact on the quality of life of people with multiple sclerosis, irrespective of clinical phenotype. Mult. Scler 27(8), 1262–1275 (2021) 3. Chen, J., Taylor, B., Winzenberg, T., Palmer, A.J., Kirk-Brown, A., van Dijk, P., Simpson, S., Jr., Blizzard, L., van der Mei, I.: Comorbidities are prevalent and detrimental for employment outcomes in people of working age with multiple sclerosis. Mult. Scler. 26(12), 1550–1559 (2020) 4. Ahmad, H., Campbell, J.A., van der Mei, I., Taylor, B., Palmer, A.J.: Health economic impact of multiple sclerosis in Australia in 2017: an analysis of MS research Australia's platform-the Australian MS Longitudinal Study (AMSLS). Contract Report (2018) 5. The Multiple Sclerosis International Federation, Atlas of MS, 3rd Edition (2020)
|
|