Abstract
Background
Generic health preference measures that capture quality of life improvements in depression are important for economic analysis of new technologies.
Aim
To compare two widely used preference measures, the EQ-5D and SF-6D, in terms of their dimensions and health utility values.
Method
EQ-5D and SF-6D data collected from 114 patients with depression, who participated in a cluster, randomised controlled trial to evaluate a collaborative care intervention in UK, primary care practices. Utilities were examined across the whole sample and by level of depression severity using the PHQ-9.
Results
Depression was associated with disutility at baseline. At 3 month follow-up mean utility increased 0.147 for EQ-5D and 0.082 for SF-6D. Health gains were observed in patients in remission from depression and those with the mildest level of depression severity.
Conclusions
Both generic preference measures were sensitive to health gains in depression within a relatively short follow-up period; larger health gain was observed for the EQ-5D.
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References
Brazier J, Deverill M, Green C, Harper R, Booth A (1999) A review of the use of health status measures in economic evaluation. Health Technol Assess 3:1–164
Brazier J, Roberts J, Deverill M (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21:271–292
Brazier JE, Akehurst R, Brennan A, Dolan P, Claxton K, McCabe C, Sculpher M, Tsuchyia A (2005) Should patients have a greater role in valuing health states? Appl Health Econ Health Policy 4(4):201–208
Brazier JE, Ratcliffe J, Tsuchiya A, Salomon J (2007) Measuring and valuing health benefits for economic evaluation. Oxford University Press, Oxford
Brazier JE, Roberts J, Tsuchiya A, Busschbach J (2004) A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 13:873–884
CCOHTA (1997) Guidelines for the economic evaluation of pharmaceuticals. Canadian Coordinating Office for Health Technology Assessment, Ottawa
Donaldson C, Currie G, Mitton C (2002) Cost effectiveness analysis in health care: contraindications. BMJ 325:891–894
First M, Spitzer R, Gibbon M, Williams J (1996) Structured clinical interview schedule for DSM-IV axis/disorders, Clinical Version, (SCID-CV). American Psychiatric Press, Washington DC
Gilbody S, Richards D, Barkham M (2007) Diagnosing depression in primary care using self-completed instruments: UK validation of PHQ-9 and CORE-OM. Br J Gen Pract 57:650–652
Gilbody S, Richards D, Brearly S, Hewitt C (2007) Screening for depression in medical settings with the patient health questionnaire (PHQ): a diagnostic meta-analysis. J Gener Int Med (in press)
Gold MR (1996) Cost-effectiveness in health and medicine. Oxford University Press, New York
Gunther OH, Roick C, Angermeyer MC, Konig H-H (2008) The responsiveness of EQ-5D utility scores in patients with depression: a comparison with instruments measuring quality of life, psychopathology and social functioning. J Affect Disord (in press)
Kaltenthaler E, Brazier J, De Nigris E, Tumur I, Ferriter M, Beverley C, Parry G, Rooney G, Sutcliffe P (2006) Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technol Assess 10:iii, xi-xiv, 1–168
Kroenke K, Spitzer R (2002) The PHQ-9: a new depression and diagnostic severity measure. Psychiatric Ann 32:509–521
Lamers LM, Bouwmans C, van Straten A, Donker M, Hakkaart L (2006) Comparison of EQ-5D and SF-6D utilities in mental health patients. Health Econ 15:1229–1236
Layard R (2006) The case for psychological treatment centres. BMJ 332:1030–1032
Longworth L, Bryan S (2003) An emprical comparison of EQ-5D and SF-6D in liver transplant patients. Health Econ 12:1061–1067
NICE (2007) Antenatal and postnatal mental health: clinical guideline (CG45). HMSO, London
NICE (2004) Depression: core interventions in the management of depression in primary care and secondary care. HMSO, London
NICE (2004) Guide to the methods of technology appraisal. HMSO, London
Papakostas GI, Petersen T, Mahal Y, Mischoulon D, Nierenberg AA, Fava M (2004) Quality of life assessments in major depressive disorder: a review of the literature. General Hospital Psychiatry 26:13–17
Peveler R, Kendrick T, Buxton M, Longworth L, Baldwin D, Moore M, Chatwin J, Goddard J, Thornett A, Smith H, Campbell M, Thompson C (2005) A randomised controlled trial to compare the cost-effectiveness of tricyclic antidepressants, selective serotonin reuptake inhibitors and lofepramine. Health Technol Assess 9:1–134
Rawlins MD (2004) NICE work—providing guidance to the British National Health Service. N Engl J Med 351:1383–1385
Rawlins MD, Culyer AJ (2004) National Institute for clinical excellence and its value judgments. BMJ 329:224–227
Revicki DA, Wood M (1998) Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications. J Affect Disord 48:25–36
Richards D, Lovell K, Gilbody S, Gask L, Torgerson D, Barkham M, Bland M, Bower P, Lankshear A, Simpson A, Fletcher J, Escott D, Henessey S, Richardson R (2007) Collaborative care for depression in UK primary care: a randomized controlled trial. Psychol Med (in press)
Sapin C, Fantino B, Nowicki M-L, Kind P (2004) Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health Qual Life Outcomes 2:20
Donald Sherbourne C, Unutzer J, Schoenbaum M, Duan N, Lenert LA, Sturm R, Wells KB (2001) Can utility-weighted health-related quality-of-life estimates capture health effects of quality improvement for depression? Med Care 39:1246–1259
Sobocki P, Ekman M, Agren H, Krakau I, Runeson B, Martensson B, Jonsson B (2007) Health-related quality of life measured with EQ-5D in patients treated for depression in primary care. Value Health 10:153–160
SPSS (2005) SPSS Base 14.0 User’s Guide. SPSS Inc, Chicago
The EuroQol Group (1990) EuroQol-a new facility for the measurement of health related quality of life. The EuroQol Group. Health Policy 16:199–208
Thomas CM, Morris S (2003) Cost of depression among adults in England in 2000. Br J Psychiatry 183:514–519
Ware JE, Gandek B, Kosinski M, Snow KK (1993) SF-36 health survey: manual and interpretation guide. The Health Institute New England Medical Center, Boston
Williams A (1995) The measurement and valuation of health: a chronicle. discussion paper 136. In: Centre for health economics. York Health Economics Consortium, The University of York
World Health Organisation (2001) The World Health Report 2001: mental health: new understanding: new hope. World Health Organisation, Geneva
Acknowledgments
We acknowledge the contribution of co-investigators and participants in the UK MRC collaborative care trial (grant number G03000677, ISRCT 63222059). We are grateful for the comments from two anonymous referees to an earlier version of the paper. Conflict of interest None.
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R. Mann contributed to the analysis and interpretation of the data, the drafting of the manuscript and the final revisions. S. Gilbody contributed to the drafting of the manuscript and the final revisions. D. Richards contributed to the final approval of the version for publication
Appendices
Appendix 1
Appendix 2
Distribution of EQ-5D utility values at baseline
Distribution of SF-6D utility values at baseline
Distribution of EQ-5D utility values at follow-up
Distribution of SF-6D utility values at follow-up
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Mann, R., Gilbody, S. & Richards, D. Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures. Soc Psychiat Epidemiol 44, 569–578 (2009). https://doi.org/10.1007/s00127-008-0463-5
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DOI: https://doi.org/10.1007/s00127-008-0463-5