Key result
Most heart failure studies use generic measures for QALYs with only ~35% reporting significant gains.
Why the study?
Accurate measurement and valuation of HRQoL are essential for deriving QALYs, motivating an assessment of how trial-based economic evaluations in heart failure measure and value HRQoL changes.
What are the approaches used to measure and value change in health-related quality of life to derive QALYs in trial-based economic evaluations of heart failure interventions?
Systematic Review (n=20)
What are the approaches used to measure and value change in health-related quality of life to derive QALYs in trial-based economic evaluations of heart failure interventions?
Answers are grounded in this paper and cite their sources.
There is substantial variation in the methods used to derive QALYs in heart failure trials, with most relying on generic preference-based measures like the EQ-5D-3L, though few report significant QALY gains.
The accurate measurement of health-related quality of life (HRQoL) and the value of improving it for patients are essential for deriving quality-adjusted life years (QALYs) to inform treatment choice and resource allocation. The objective of this review was to identify and describe the approaches used to measure and value change in HRQoL in trial-based economic evaluations of heart failure interventions which derive QALYs as an outcome. Three databases (PubMed, CINAHL, Cochrane) were systematically searched. Twenty studies reporting economic evaluations based on 18 individual trials were identified. Most studies (n = 17) utilised generic preference-based measures to describe HRQoL and derive QALYs, commonly the EQ-5D-3L. Of these, three studies (from the same trial) also used mapping from a condition-specific to a generic measure. The remaining three studies used patients' direct valuation of their own health or physician-reported outcomes to derive QALYs. Only 7 of the 20 studies reported significant incremental QALY gains. Most interventions were reported as being likely to be cost-effective at specified willingness to pay thresholds. The substantial variation in the approach applied to derive QALYs in the measurement of and value attributed to HRQoL in heart failure requires further investigation.
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Rankin et al. (2019) conducted a systematic review in Heart failure (n=20). Heart failure interventions was evaluated on Approaches used to measure and value change in HRQoL to derive QALYs. In a systematic review of 20 studies on heart failure interventions, most (n=17) utilized generic preference-based measures like EQ-5D-3L to derive QALYs, with only 7 reporting significant QALY gains.
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