Skip to main content

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

Social Psychiatry and Psychiatric Epidemiology volume 44, pages 569–578 (2009)Cite this article

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  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 3:1–164

    Google Scholar 

  2. Brazier J, Roberts J, Deverill M (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21:271–292

    PubMed  Article  Google Scholar 

  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):201–208

    PubMed  Article  Google Scholar 

  4. Brazier JE, Ratcliffe J, Tsuchiya A, Salomon J (2007) Measuring and valuing health benefits for economic evaluation. Oxford University Press, Oxford

    Google Scholar 

  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 13:873–884

    PubMed  Article  Google Scholar 

  6. CCOHTA (1997) Guidelines for the economic evaluation of pharmaceuticals. Canadian Coordinating Office for Health Technology Assessment, Ottawa

    Google Scholar 

  7. Donaldson C, Currie G, Mitton C (2002) Cost effectiveness analysis in health care: contraindications. BMJ 325:891–894

    PubMed  Article  Google Scholar 

  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 DC

    Google Scholar 

  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 57:650–652

    PubMed  Google Scholar 

  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)

  11. Gold MR (1996) Cost-effectiveness in health and medicine. Oxford University Press, New York

    Google Scholar 

  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)

  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, 1–168

    PubMed  CAS  Google Scholar 

  14. Kroenke K, Spitzer R (2002) The PHQ-9: a new depression and diagnostic severity measure. Psychiatric Ann 32:509–521

    Google Scholar 

  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 15:1229–1236

    PubMed  Article  CAS  Google Scholar 

  16. Layard R (2006) The case for psychological treatment centres. BMJ 332:1030–1032

    PubMed  Article  Google Scholar 

  17. Longworth L, Bryan S (2003) An emprical comparison of EQ-5D and SF-6D in liver transplant patients. Health Econ 12:1061–1067

    PubMed  Article  Google Scholar 

  18. NICE (2007) Antenatal and postnatal mental health: clinical guideline (CG45). HMSO, London

    Google Scholar 

  19. NICE (2004) Depression: core interventions in the management of depression in primary care and secondary care. HMSO, London

    Google Scholar 

  20. NICE (2004) Guide to the methods of technology appraisal. HMSO, London

    Google Scholar 

  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 26:13–17

    PubMed  Article  Google Scholar 

  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 9:1–134

    PubMed  CAS  Google Scholar 

  23. Rawlins MD (2004) NICE work—providing guidance to the British National Health Service. N Engl J Med 351:1383–1385

    PubMed  Article  CAS  Google Scholar 

  24. Rawlins MD, Culyer AJ (2004) National Institute for clinical excellence and its value judgments. BMJ 329:224–227

    PubMed  Article  Google Scholar 

  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 48:25–36

    PubMed  Article  CAS  Google Scholar 

  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. 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

    PubMed  Article  Google Scholar 

  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 39:1246–1259

    PubMed  Article  CAS  Google Scholar 

  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 10:153–160

    PubMed  Article  Google Scholar 

  30. SPSS (2005) SPSS Base 14.0 User’s Guide. SPSS Inc, Chicago

    Google Scholar 

  31. The EuroQol Group (1990) EuroQol-a new facility for the measurement of health related quality of life. The EuroQol Group. Health Policy 16:199–208

    Article  Google Scholar 

  32. Thomas CM, Morris S (2003) Cost of depression among adults in England in 2000. Br J Psychiatry 183:514–519

    PubMed  Article  Google Scholar 

  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, Boston

    Google Scholar 

  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 York

  35. World Health Organisation (2001) The World Health Report 2001: mental health: new understanding: new hope. World Health Organisation, Geneva

    Google Scholar 

Download references

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.

Author information

Affiliations

  1. Dept. of Health Sciences, University of York, York, YO10 5DD, UK

    Rachel Mann MSc,  Simon Gilbody DPhil, MRCPsych &  David Richards PhD

Authors
  1. Rachel Mann MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simon Gilbody DPhil, MRCPsych
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Richards PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rachel Mann MSc.

Additional information

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

Table 7 EQ-5D and SF-6D description of dimensions and levels
Full size table

Appendix 2

Table 8 Distribution of utility values and test of normality
Full size table
Fig. 3
figure 3

Distribution of EQ-5D utility values at baseline

Full size image
Fig. 4
figure 4

Distribution of SF-6D utility values at baseline

Full size image
Fig. 5
figure 5

Distribution of EQ-5D utility values at follow-up

Full size image
Fig. 6
figure 6

Distribution of SF-6D utility values at follow-up

Full size image

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-008-0463-5

Keywords

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