Why the study?
Utility values are required for economic evaluations in COPD, and an update to a 2016 review was needed to examine changes in mean utilities and explore heterogeneity across clinical and study characteristics in more recent studies.
The pooled mean EQ-5D utility value for COPD patients is 0.761, showing an improvement over the past decade, though significant heterogeneity exists based on elicitation method, disease stage, and region.
Updated utilities exceed 2016 estimates; extends prior meta-analysis but heterogeneity leaves general values open for cost-utility models.
Chronic obstructive pulmonary disease (COPD) is a common lung disease that negatively affects health-related quality of life (QoL). Utility values, which measure QoL by weighting health states with societal preferences, are required for the cost-utility models that drive economic evaluations and policy decisions. Moayeri et al. published a systematic review and meta-analysis of utilities (EQ-5D) in COPD in June 2016. The current study investigated changes in mean utilities in more recent studies thereafter, exploring heterogeneity in utilities across diverse clinical and study characteristics. Systematic searches of databases, such as MEDLINE and Embase were undertaken from 1 July 2015 until 20 May 2024. A random-effects meta-analysis of utilities (EQ-5D) was performed which addressed inter-study heterogeneity and subgroup analyses. The pooled general mean (95% CI) utility value was 0.761 (0.726-0.795) from 43 studies, whereas Moayeri et al. reported 0.673 (0.653-0.693) from 32 studies. This improvement in mean utilities could be due to increased awareness, early detection, and better medical interventions over the past decade, but demonstrates that a general utility value should be approached with caution given significant heterogeneity. Four meta-regressions were performed on each subgroup: region, method of elicitation, reported comorbidities, and disease stage; of which, method of elicitation, disease stage, and region were found to be significant moderators of utilities. It is, therefore, important to use meta-analysed utilities for cost-utility analyses that reflect the context and patient population of the model. Moreover, these results provide additional evidence for the precision and sensitivity of EQ-5D-5L over EQ-5D-3L.
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Salant et al. (2024) studied this question.
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