The use of health utility in cost-utility analysis: A systematic review in substance use disorders

Anh Dam Tran; Xin Zhan; Annaëlle Vinzent; Lorelie Flood; Tian Bai; Erinn Gallagher; Gregory S Zaric

doi:10.1016/j.drugpo.2024.104570

The use of health utility in cost-utility analysis: A systematic review in substance use disorders

Int J Drug Policy. 2024 Nov:133:104570. doi: 10.1016/j.drugpo.2024.104570. Epub 2024 Oct 9.

Authors

Anh Dam Tran¹, Xin Zhan², Annaëlle Vinzent³, Lorelie Flood⁴, Tian Bai², Erinn Gallagher³, Gregory S Zaric⁵

Affiliations

¹ National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Sydney, Australia; NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Sydney, Australia. Electronic address: a.tran@sydney.edu.au.
² NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Sydney, Australia.
³ National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Sydney, Australia.
⁴ National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Sydney, Australia; NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Sydney, Australia.
⁵ Richard Ivey School of Business, Western Ontario University, London N6A 3K7, Canada.

PMID: 39388917
DOI: 10.1016/j.drugpo.2024.104570

Abstract

Background and aim: We aim to identify within-trial and modelled Cost-Utility Analysis (CUA) in substance use disorders (SUD) and review the applicability assessment associated with health utility used in modelled CUA.

Study design and methods: We searched Medline, Embase, EconLit and the Pharmaceutical Benefits Advisory Committee (PBAC) databases. A global systematic literature search was undertaken to determine the CUA of SUD interventions. Key characteristics of the studies and use of health utility were described. The applicability assessment associated with health utility used in modelled CUA was reviewed using The Health Utility Application Tool (HAT).

Results: The final review retrieved 49 CUA (14 within-trial and 35 modelled CUA). Three major health utility measurements were used - standard gamble, EQ-5D-5L and SF-6D. EQ-5D-5L was mainly used in within-trial CUA, whereas standard gamble, EQ-5D-5L and SF-6D were equally cited in modelled CUA and within-trial CUA. Twenty-nine articles using modelled CUA citing health utilities from published literature were assessed. Only half and one-third of CUA studies described the type of quality-of-life measure and value sets used in health utility studies, respectively. Only two-thirds showed the authors addressed questions about the similarities in clinical conditions, and health state description between health utility studies and economic evaluation studies.

Conclusion: Justifications for chosen health utilities in modelled CUA studies were mostly absent in SUD. We suggested health economists use the HAT to make judgements when assessing health utility from published estimates. The use of this tool will increase the reliability of economic evaluation carried out to assist government and policymakers in making informed decisions around health topics.

Keywords: Cost-utility analysis; Health utility; Health utility application tool; Health-related quality of life; Substance use disorders; Systematic review.

Publication types

Systematic Review
Review

MeSH terms

Cost-Benefit Analysis*
Health Status
Humans
Quality of Life
Quality-Adjusted Life Years
Substance-Related Disorders* / economics