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Towards Transparency in the Selection of Published Health Utility Inputs in Cost-Utility Analyses: The Health Utility Application Tool (HAT)

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Abstract

Background

Evaluating the relevance of published health utilities to the context of a cost-utility analysis (CUA) remains an essential, yet often overlooked, task.

Objective

The objective of this study was to provide guidance on this process through the development of the Health utility Application Tool (HAT).

Methods

We conducted semi-structured telephone interviews with Canadian stakeholders from reimbursement bodies, academia, and the pharmaceutical industry to identify current practices and perspectives of the application of the health utility literature to CUAs. An online survey with international members of the general health economics and outcomes research community was also conducted to gather opinions on key concepts.

Results

Based on the themes emerging from the interviews and online questionnaire, the HAT includes questions prompting investigators to consider the following constructs: similarity of the clinical condition in the health utility study and the CUA; similarity of health utility study participant demographics and the demographics of the CUA’s target population; similarity of the health state descriptions in the health utility study and the CUA; and the method of assigning utility weights. Considerations of transparency prompted additional items, including: means by which the health utility study was identified; type of respondents; study design; and measure used to collect health utility estimates.

Conclusion

The HAT is intended to guide the evaluation of the applicability of published health utilities for a CUA, thus promoting transparency and accountability in the selection of model inputs.

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Acknowledgements

The Health Utility Book (HUB) Working Group members: Feng Xie, Michael J. Zoratti, Kelvin K. W. Chan, Don Husereau, Murray Krahn, Holger Schunemann, and Gordon Guyatt. The authors thank everyone who contributed to the development of this tool through either a telephone interview or a response to our online survey. While all participants had the option of remaining anonymous, the following have agreed to be acknowledged: Kabirraaj Toor, Whitney Longstaff, Colin Vicente, Lauren Cipriano, Donna Lawrence, Brittany Humphries, Wendy Ungar, A. Simon Pickard, Ahmed M. Y. Osman, Alex Li, Bernhard Michalowsky, Bin Wu, Boxiong Tang, Chang, Chao Wang, Charlene Niu, Chen, Chris Cameron, Ena Pery Niño de Guzman, Ernest Law, Gian Paolo Morgano, Gina, Graeme Ball, Haijing Guan, Hansen, Henry J. Conter, Hongchao Li, James W. Shaw, Jeffrey Johnson, Jie You, Jing Wu, Juan M Cabasés, Junwei Gao, Junwen Zhou, Lei Si, Lidia García, Marisa da Silva Santos, Matthijs Versteegh, Melina Leng, Nathan McClure, Nigar Sekercioglu, Olga Veljanoski, Paula Lorgelly, Peijing Yan, Rachel Harrington, Rosalie Viney, Shan Jiang, Sheng Wang, Sumeet Singh, Tania Conte, Tara Lavelle, Ting Zhou, Valentina Rupel, Weijin Fang, Wenying He, Xiangli Cui, Xiaoping, Xue Li, Yangwei, Yangyi, Zhiyuan Chen, and Huijun Zhou.

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Authors and Affiliations

  1. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

    Michael J. Zoratti, Mitchell Levine, Lehana Thabane & Feng Xie

  2. Sunnybrook Odette Cancer Centre, Toronto, ON, Canada

    Kelvin K. W. Chan

  3. Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada

    Kelvin K. W. Chan

  4. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada

    Don Husereau

  5. Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada

    Murray Krahn

  6. Department of Medicine, Division of Clinical Pharmacology and Toxicology, McMaster University, Hamilton, ON, Canada

    Mitchell Levine

  7. St Joseph’s Healthcare-Hamilton, Hamilton, ON, Canada

    Lehana Thabane

  8. Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada

    Feng Xie

  9. Program for Health Economics and Outcome Measures (PHENOM), Hamilton, ON, Canada

    Feng Xie

  10. Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada

    Murray Krahn

Authors
  1. Michael J. Zoratti
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  2. Kelvin K. W. Chan
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  3. Don Husereau
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  4. Murray Krahn
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  5. Mitchell Levine
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  6. Lehana Thabane
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  7. Feng Xie
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Consortia

the Health Utility Book (HUB) Working Group

Corresponding author

Correspondence to Feng Xie.

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Funding

No funding was received for this study.

Conflict of interest

Michael J. Zoratti, Kelvin K. W. Chan, Mitchell Levine, Lehana Thabane, Murray Krahn, and Feng Xie declare no financial or other relationships that may lead to a real or perceived conflict of interest. Don Husereau has consulted for HTA organizations and life sciences companies who may have an interest in this work.

Availability of data and material

Anonymized data may be provided upon written request to the study authors.

Code availability

Not applicable.

Author contributions

All authors conceived the study concept. MZ and FX collected and conducted an initial interpretation of the data, and drafted the initial manuscript. All authors provided critical revisions to the manuscript, and all authors approved the final version of the manuscript.

Additional information

The Health Utility Book (HUB) Working Group members are listed in the Acknowledgement section.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 24 kb)

Supplementary file2 (DOCX 231 kb)

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Zoratti, M.J., Chan, K.K.W., Husereau, D. et al. Towards Transparency in the Selection of Published Health Utility Inputs in Cost-Utility Analyses: The Health Utility Application Tool (HAT). PharmacoEconomics 39, 1075–1084 (2021). https://doi.org/10.1007/s40273-021-01039-0

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  • DOI: https://doi.org/10.1007/s40273-021-01039-0

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