Generating consistent health state utilities and QALYs across the life-course from cradle to grave

Theme 2: Measuring and Valuing Outcomes

Economic evaluation of health and social care interventions can require QALYs for a lifetime (quality adjusted life years) that require the generation of utility values from very young ages to old ages. However none of the available preference-weighted measures that can be used to generate QALYs are recommended for use from infants through to the elderly. Different measures of health are typically required for infants (e.g. EQ-TIPS), children and adolescents (e.g. EQ-5D-Y, CHU9D) and adults (typically EQ-5D-5L in the UK context) which will become especially important for conditions including those starting in infancy/childhood, gene therapies and vaccines. This means that both the measures change across the age of the patient, with some changes in dimensions and severity levels, but also the health state utility values that are generated by different measures change. In the UK there are new EQ-5D-5L and EQ-5D-Y value sets in progress that are expected to be based on different valuation protocols generating value sets both from different methodologies (e.g. different populations, different elicitation tasks, different people imagined living in the health state). 

Aims

The project aim is to develop a better understanding of the problem and potential solutions to generate consistent health state utility values and hence QALYs across the life course to inform the economic evaluation of health and social care interventions.

The project objectives are: 

1) To better understand the importance, characteristics and implications of the issue that leads to utility and QALY changes when switching between measures across the life course (e.g. EQ-5D-Y to EQ-5D-5L, EQ-TIPS to EQ-5D-Y); 

2) To examine a range of potential solutions and their associated pros and cons; 

3) To undertake detailed scoping of at least two feasible and appropriate solutions to the issue, with the potential to develop research proposals to provide an acceptable solution.

Project Team

Donna Rowen, Anju Keetharuth, Tess Peasgood

Contact

Donna Rowen d.rowen@sheffield.ac.uk