Advertisement

Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures

  • Rachel MannEmail author
  • Simon Gilbody
  • David Richards
ORIGINAL PAPER

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.

Keywords

health related utility EQ-5D SF-6D quality of life outcomes measurement 

Notes

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.

References

  1. 1.
    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 3:1–164Google Scholar
  2. 2.
    Brazier J, Roberts J, Deverill M (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21:271–292PubMedCrossRefGoogle Scholar
  3. 3.
    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):201–208PubMedCrossRefGoogle Scholar
  4. 4.
    Brazier JE, Ratcliffe J, Tsuchiya A, Salomon J (2007) Measuring and valuing health benefits for economic evaluation. Oxford University Press, OxfordGoogle Scholar
  5. 5.
    Brazier JE, Roberts J, Tsuchiya A, Busschbach J (2004) A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 13:873–884PubMedCrossRefGoogle Scholar
  6. 6.
    CCOHTA (1997) Guidelines for the economic evaluation of pharmaceuticals. Canadian Coordinating Office for Health Technology Assessment, OttawaGoogle Scholar
  7. 7.
    Donaldson C, Currie G, Mitton C (2002) Cost effectiveness analysis in health care: contraindications. BMJ 325:891–894PubMedCrossRefGoogle Scholar
  8. 8.
    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 DCGoogle Scholar
  9. 9.
    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 57:650–652PubMedGoogle Scholar
  10. 10.
    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)Google Scholar
  11. 11.
    Gold MR (1996) Cost-effectiveness in health and medicine. Oxford University Press, New YorkGoogle Scholar
  12. 12.
    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)Google Scholar
  13. 13.
    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, 1–168PubMedGoogle Scholar
  14. 14.
    Kroenke K, Spitzer R (2002) The PHQ-9: a new depression and diagnostic severity measure. Psychiatric Ann 32:509–521Google Scholar
  15. 15.
    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 15:1229–1236PubMedCrossRefGoogle Scholar
  16. 16.
    Layard R (2006) The case for psychological treatment centres. BMJ 332:1030–1032PubMedCrossRefGoogle Scholar
  17. 17.
    Longworth L, Bryan S (2003) An emprical comparison of EQ-5D and SF-6D in liver transplant patients. Health Econ 12:1061–1067PubMedCrossRefGoogle Scholar
  18. 18.
    NICE (2007) Antenatal and postnatal mental health: clinical guideline (CG45). HMSO, LondonGoogle Scholar
  19. 19.
    NICE (2004) Depression: core interventions in the management of depression in primary care and secondary care. HMSO, LondonGoogle Scholar
  20. 20.
    NICE (2004) Guide to the methods of technology appraisal. HMSO, LondonGoogle Scholar
  21. 21.
    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 26:13–17PubMedCrossRefGoogle Scholar
  22. 22.
    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 9:1–134PubMedGoogle Scholar
  23. 23.
    Rawlins MD (2004) NICE work—providing guidance to the British National Health Service. N Engl J Med 351:1383–1385PubMedCrossRefGoogle Scholar
  24. 24.
    Rawlins MD, Culyer AJ (2004) National Institute for clinical excellence and its value judgments. BMJ 329:224–227PubMedCrossRefGoogle Scholar
  25. 25.
    Revicki DA, Wood M (1998) Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications. J Affect Disord 48:25–36PubMedCrossRefGoogle Scholar
  26. 26.
    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)Google Scholar
  27. 27.
    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 2:20PubMedCrossRefGoogle Scholar
  28. 28.
    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 39:1246–1259PubMedCrossRefGoogle Scholar
  29. 29.
    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 10:153–160PubMedCrossRefGoogle Scholar
  30. 30.
    SPSS (2005) SPSS Base 14.0 User’s Guide. SPSS Inc, ChicagoGoogle Scholar
  31. 31.
    The EuroQol Group (1990) EuroQol-a new facility for the measurement of health related quality of life. The EuroQol Group. Health Policy 16:199–208CrossRefGoogle Scholar
  32. 32.
    Thomas CM, Morris S (2003) Cost of depression among adults in England in 2000. Br J Psychiatry 183:514–519PubMedCrossRefGoogle Scholar
  33. 33.
    Ware JE, Gandek B, Kosinski M, Snow KK (1993) SF-36 health survey: manual and interpretation guide. The Health Institute New England Medical Center, BostonGoogle Scholar
  34. 34.
    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 YorkGoogle Scholar
  35. 35.
    World Health Organisation (2001) The World Health Report 2001: mental health: new understanding: new hope. World Health Organisation, GenevaGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2008

Authors and Affiliations

  1. 1.Dept. of Health SciencesUniversity of YorkYorkUK

Personalised recommendations