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Health State Utility Values in Schizophrenia: A Systematic Review and Meta-Analysis

Lookup NU author(s): Dr Mark Pennington, Professor Matthew Prina

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Abstract

© 2020 ISPOR–The Professional Society for Health Economics and Outcomes Research. Objectives: Patient preferences are increasingly important in informing clinical and policy decisions. Health-state utility values (HSUVs) are quantitative measures of people's preferences over different health states. In schizophrenia, there is no clarity about HSUVs across the symptoms’ severity spectrum. This meta-analysis aims to synthesize the literature on HSUVs in people with schizophrenia. Methods: We searched Medline, PsycInfo, Embase, EconLit, The Cochrane Library, and specialized databases. The studies reporting HSUVs in people with schizophrenia were selected and pooled in a random-effects meta-analysis. The primary outcome was the mean HSUV obtained from participants. Results: A total of 54 studies involving 87 335 participants were included. The pooled estimate using direct elicitation was a mean HSUV of 0.79 (95% CI: 0.70-0.88) for mild symptomatic states, 0.69 (95% CI: 0.54-0.85) in moderate states, and 0.34 (95% CI: 0.13-0.56) in severe states. Studies using indirect techniques resulted in a pooled mean HSUV of 0.73 (95% CI: 0.67-0.78) applying the EuroQol 5-dimension, 0.66 (95% CI: 0.62-0.71) in the Short-Form 6-dimension, and 0.59 (95% CI: 0.57-0.61) using the Quality of Well-Being scale. All the estimates resulted in considerable heterogeneity, partially reduced by meta-regression. Conclusion: Our findings suggest that the severity of psychotic symptoms has an important effect on HSUVs in schizophrenia, with values mirroring patients with disabling physical conditions such as cancer and stroke. Decision makers should be aware of these results when including people's preferences in trials, models, and policy decisions.


Publication metadata

Author(s): Aceituno D, Pennington M, Iruretagoyena B, Prina AM, McCrone P

Publication type: Review

Publication status: Published

Journal: Value in Health

Year: 2020

Volume: 23

Issue: 9

Pages: 1256-1267

Print publication date: 01/09/2020

Online publication date: 01/08/2020

Acceptance date: 20/05/2020

ISSN (print): 1098-3015

ISSN (electronic): 1524-4733

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.jval.2020.05.014

DOI: 10.1016/j.jval.2020.05.014

PubMed id: 32940244


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