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An updated systematic review of Health State Utility Values for osteoporosis related conditions

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Abstract

Introduction

An important component of cost effectiveness models in the field of osteoporosis is the set of Health State Utility Values (HSUVs) used for key fracture outcomes. This paper presents a review of HSUVs for key osteoporotic states (hip, wrist, shoulder, clinical, and morphometric vertebral fractures, established osteoporosis, and interaction of several fractures). It provides an update to the systematic review conducted by Brazier et al. (Osteoporos Int 13(10):768–776, 2002).

Materials and methods

A systematic search was undertaken of the main literature databases for HSUVs for established osteoporosis, vertebral, hip, wrist, and shoulder fractures were identified. Studies meeting the inclusion criteria were reviewed in terms of the patient population, the method of describing health (if not obtained directly from patients), the method of valuing health states and the source of values.

Results

Estimates of Health State Utility Values were found across the osteoporosis conditions from 27 studies. A wide range of empirical estimates were found, partly due to differences in valuation technique (VAS, SG, TTO), descriptive system and differences in respondents (population or patient), the perspective of the task (own health or a scenario), sample size, and study quality.

Conclusion

The paper provides a set of multipliers representing the loss in HSUVs for use as a “reference case” in cost-effectiveness models.

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Notes

  1. These were: Cochrane Controlled Trials Register/Central, Cochrane Database of systematic Reviews, EMBASE, Science Citation Index (Institute for Scientific Information), MEDLINE, MEDLINE in Process, NHS Database of Abstracts of Reviews of Effectiveness (DARE), NHS Economic Evaluation Database (NHS EED), Index to Theses, ISI Proceedings.

  2. The years 2000–2003 were not searched as it was considered articles found here would already have been published.

  3. EQ-5D utility values are available for the UK [25, 26], for Sweden [27], and the US [28–30].

  4. Poorer functioning (assessed by SF-36 questionnaire) is associated with lower total femoral BMD in middle-aged men (but less so in women) adjusting for known co-morbidities [35].

  5. For the non-fracture group, valuations are cascaded from an initial valuation anchored by dead and current health, then rescaled based on a TTO valuation of own health anchored at dead and best imaginable for ones age.

  6. By dual-energy X-ray absorptiometry (DXA), using the XR-36

  7. http://www.medscinet.com/IcurosTest/default.aspx.

  8. Merlino et al. [52] study fractures among rheumatoid arthritis patients, and also find that utility states for a hypothetical hip fracture were lower among those had not experienced an osteoporotic fracture than for those who had previously experienced a fracture. However, sample sizes are small.

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Funding

This study review was funded by Lilly. John Brazier is funded by the UK Medical Research Council.

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Authors and Affiliations

  1. Health Economics and Decision Science, School of Health and Related Research, University of Sheffield Regent Court, Court, 30 Regent Street, Sheffield, UK, S1 4DA

    T. Peasgood, K. Herrmann & J. E. Brazier

  2. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Beech Hill Road, Sheffield, UK, S10 2RX

    J. A. Kanis

Authors
  1. T. Peasgood
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  2. K. Herrmann
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  3. J. A. Kanis
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  4. J. E. Brazier
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Correspondence to J. E. Brazier.

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Peasgood, T., Herrmann, K., Kanis, J.A. et al. An updated systematic review of Health State Utility Values for osteoporosis related conditions. Osteoporos Int 20, 853–868 (2009). https://doi.org/10.1007/s00198-009-0844-y

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