Health state utility values measured using the EuroQol 5-dimensions questionnaire in adults with chronic hepatitis C: a systematic literature review and meta-analysis
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Chronic hepatitis C infection and its treatment can considerably affect patients’ health-related quality-of-life (HRQoL). This study aimed to identify and summarise the current evidence base for health state utility values (HSUVs) in patients with chronic hepatitis C infection, generated using the EuroQol 5-dimensions (EQ-5D) questionnaire.
MEDLINE, Embase, the Cochrane Library and EconLit were searched from database inception through 31 August 2017. Eligible studies reported HSUVs elicited using the EQ-5D questionnaire in adults with chronic hepatitis C infection. Study quality and risk of bias were assessed.
Of 1480 records identified, 26 studies were included. The most commonly defined health states described different stages of chronic hepatitis C infection and specific liver-related disease states, including METAVIR score, compensated and decompensated cirrhosis, hepatocellular carcinoma and liver transplantation. Patients with higher METAVIR scores tended to have lower EQ-5D scores compared to patients with lower METAVIR scores. Patients that achieved sustained virologic responses tended to have higher EQ-5D scores compared to those that did not. A meta-analysis conducted on three studies confirmed that patients with decompensated cirrhosis have significantly lower HSUVs than patients with compensated cirrhosis [mean difference − 0.11 (95% CI − 0.19 to − 0.04)], implying worse HRQoL. However, there was not sufficient evidence to compare how different treatments for chronic hepatitis C infection affect EQ-5D scores.
This study provides a summary of EQ-5D HSUVs for patients with chronic hepatitis C infection, and demonstrates that clinically important disease stages associated with treatment decisions are associated with differences in HRQoL.
KeywordsEQ-5D HCV Hepatitis C QoL Quality of life Utility
ABH, KH, BL, LE and David Slater performed the abstract and full-text sifts. ABH, KH, LE and David Slater performed extractions of the included studies. BL performed the meta-analysis.
This study was funded by Gilead Sciences Europe Ltd.
Compliance with ethical standards
Conflict of interest
ABH, KH, BL and LE are employees of Costello Medical Consulting Ltd. David Slater was an employee at Costello Medical Consulting Ltd. at the time the SLR was conducted. MB has received research grants from Gilead, Merck Sharp & Dohme and AbbVie. MW has received speaker honoraria and participated in advisory boards for Gilead, AbbVie and Merck Sharp & Dohme.
Research involving human participants and/or animals
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study formal consent is not required.
- 1.World Health Organization (2018). Hepatitis C. http://www.who.int/mediacentre/factsheets/fs164/en/. Accessed July 19, 2018.
- 7.Lawitz, E., Gane, E., Pearlman, B., Tam, E., Ghesquiere, W., Guyader, D., et al. (2015). Efficacy and safety of 12 weeks versus 18 weeks of treatment with grazoprevir (MK-5172) and elbasvir (MK-8742) with or without ribavirin for hepatitis C virus genotype 1 infection in previously untreated patients with cirrhosis and patients with previous null response with or without cirrhosis (C-WORTHY): A randomised, open-label phase 2 trial. The Lancet, 385(9973), 1075–1086.CrossRefGoogle Scholar
- 8.European Medicines Agency (2005). Reflection Paper on the Regulatory Guidance for the Use of Health-Related Quality of Life (HRQL) Measures in the Evaluation of Medicinal Products, https://www.ispor.org/workpaper/emea-hrql-guidance.pdf. Accessed July 19, 2017.
- 9.Kastien-Hilka, T., Abulfathi, A., Rosenkranz, B., Bennett, B., Schwenkglenks, M., Sinanovic, E. (2016). Health-related quality of life and its association with medication adherence in active pulmonary tuberculosis—A systematic review of global literature with focus on South Africa. Health and Quality of Life Outcomes, 42(14), 1–13.Google Scholar
- 10.EuroQoL (2017). How to use EQ-5D. https://euroqol.org/eq-5d-instruments/. Accessed July 19, 2017.
- 11.National Institute of Health and Care Excellence (2013). Guide to the methods of technology appraisal 2013. https://www.nice.org.uk/process/pmg9/resources/guide-to-the-methods-of-technology-appraisal-2013-pdf-2007975843781. Accessed July 19, 2018.
- 12.Drummond, M. E., Sculpher, M. J., Torrance G. W., et al. (2005). Methods for the eocnomic evaluation of health care programmes (3rd ed.). Oxford: Oxford University Press.Google Scholar
- 15.EuroQoL. (2017). Search engine for EuroQol and EQ-5D-related material. https://euroqol.org/. Accessed Sept 2017.
- 16.Papaioannou, D., Brazier, J., & Paisley, S. (2010). NICE DSU Technical Support Document 9: The identification, review and synthesis of health state utility values from the literature. https://www.ncbi.nlm.nih.gov/books/NBK425822/pdf/Bookshelf_NBK425822.pdf. Accessed 12 Sept 2018.
- 18.Bjornsson, E., Verbaan, H., Oksanen, A., Fryden, A., Johansson, J., Friberg, S., et al. (2009). Health-related quality of life in patients with different stages of liver disease induced by hepatitis C. Scandinavian Journal of Gastroenterology, 44(7), 878–887. [Multicenter Study]CrossRefGoogle Scholar
- 22.DeVecchis Wygant, G., Mo, L., Treitel, M., Bhore, R., & Torbeyns, A. (2016). EQ-5D results in Asian patients with HCV G1b receiving DCV + ASV who are IFN intolerant/ineligible. Hepatology International, 10(Suppl 1), S142.Google Scholar
- 23.Kaishima, T., Akita, T., Aikata, H., Chayama, K., & Tanaka, J. (2016). Cost-effectiveness analysis related to HCV treatment is possible to be estimated in each province. Hepatology International, 10(Suppl 1), S148–S149.Google Scholar
- 24.McDonald, S. A., Hutchinson, S. J., Palmateer, N. E., Allen, E., Cameron, S. O., Goldberg, D. J., et al. (2013). Decrease in health-related quality of life associated with awareness of hepatitis C virus infection among people who inject drugs in Scotland. Journal of Hepatology, 58(3), 460–466.CrossRefGoogle Scholar
- 25.Nouvertne, D., Perry, R., & Milligan, G. (2014). Health-related quality of life and productivity impairment in chronic hepatitis C patients in Germany. Journal of Viral Hepatitis, 21, 34–35. [Conference Abstract]Google Scholar
- 26.Pol, S., Chevalier, J., Branchoux, S., Perry, R., Milligan, G., & Gaudin, A. F. (2015). Health related quality of life and utility values in chronic hepatitis C patients: A cross-sectional study in France, the UK and Germany. Journal of Hepatology, 62, S606. [Conference Abstract]CrossRefGoogle Scholar
- 30.Schwarzinger, M., Cossais, S., Deuffic-Burban, S., Pol, S., Fontaine, H., Larrey, D., et al. (2015). EQ-5D utility index in French patients with chronic hepatitis C (CHC) infection: Severe comorbidities and perceived progression of CHC infection matter more than actual liver disease stage. Journal of Hepatology, 62, S605.CrossRefGoogle Scholar
- 31.Scott, J., Rosa, K., Fu, M., Cerri, K., Peeters, M., Beumont, M., et al. (2014). Fatigue during treatment for hepatitis C virus: Results of self-reported fatigue severity in two Phase IIb studies of simeprevir treatment in patients with hepatitis C virus genotype 1 infection. BMC Infectious Diseases, 14(1), 465.CrossRefGoogle Scholar
- 32.Stepanova, M., Nader, F., Cure, S., Bourhis, F., Hunt, S., & Younossi, Z. M. (2014). Patients’ preferences and health utility assessment with SF-6D and EQ-5D in patients with chronic hepatitis C treated with sofosbuvir regimens. Alimentary Pharmacology and Therapeutics, 40(6), 676–685.CrossRefGoogle Scholar
- 33.Younossi, Z. M., Stepanova, M., Cure, S., Bourhis, F., Nader, F., & Hunt, S. L. (2014). Estimating health status using EQ5D for chronic hepatitis c (CH-C) patients treated with sofosbuvir (SOF) containing regimens. Journal of Hepatology, 1, S308. [Conference Abstract]Google Scholar
- 35.Vera-Llonch, M., Martin, M., Aggarwal, J., Donepudi, M., Bayliss, M., Goss, T., et al. (2013). Health-related quality of life in genotype 1 treatment-naive chronic hepatitis C patients receiving telaprevir combination treatment in the ADVANCE study. Alimentary Pharmacology and Therapeutics, 38(2), 124–133.CrossRefGoogle Scholar
- 36.Yeung, M. W., Young, J., Moodie, E., Rollet-Kurhajec, K. C., Schwartzman, K., Greenaway, C., et al. (2015). Changes in quality of life, healthcare use, and substance use in HIV/hepatitis C coinfected patients after hepatitis C therapy: A prospective cohort study. HIV Clinical Trials, 16(3), 100–110.CrossRefGoogle Scholar
- 39.Gschwantler, M., Ferenci, P., Bauer, B., Laferl, H., Bamberger, T., Stauber, R., et al. (2016). Burden of disease in patients with chronic hepatitis C in the Austrian REAL Study. Hepatology, 63(Suppl 1), 466a–467a. [Journal: Conference Abstract]Google Scholar
- 40.Huang, R., Rao, H., & Wei, L. (2017). Assessment of health-related quality of life and related factors in Chinese patients with chronic hepatitis C virus infection. Hepatology International, 11(Suppl 1), S558. [Conference Abstract]Google Scholar
- 41.Kieran, J. A., Adams, R., Chin, J. L., Mushtaq, H., McCormick, P. A., McKiernan, S., et al. (2015). Health-state utilities for patients with chronic Hepatitis C infection. Irish Journal of Medical Science, 184(6 Suppl 1), S230. [Conference Abstract]Google Scholar
- 42.Wygant, G., Mo, L., Treitel, M., & Zhao, Y. (2017). Patient reported outcomes in IFN/ribavirin intolerant/ineligible Asian patients from Mainland China receiving daclatasvir + asunaprevir for the treatment of HCV genotype 1b infection. Hepatology International, 11(Suppl 1), S1001–S1002. [Conference Abstract]Google Scholar
- 43.MVH Group (1995). The measurement and valuation of health: Final report on the modelling of valuation tariffs. York: Centre for Health Economics, University of York.Google Scholar
- 45.ClinicalTrials.gov (2017). NCT01542788 (POSITRON). https://clinicaltrials.gov/ct2/show/NCT01542788. Accessed July 19, 2018.
- 46.ClinicalTrials.gov (2017). NCT01497366 (FISSION). https://clinicaltrials.gov/ct2/show/NCT01497366. Accessed July 19, 2018.
- 47.ClinicalTrials.gov (2017). NCT01604850 (FUSION). https://clinicaltrials.gov/ct2/show/NCT01604850. Accessed July 19, 2018.
- 48.ClinicalTrials.gov (2017). NCT01641640 (NEUTRINO). https://clinicaltrials.gov/ct2/show/NCT01641640. Accessed July 19, 2018.
- 50.Richardson, J., Iezzi, A., Khan, M. A., & Maxwell, A. (2012). Cross-national comparison of twelve quality of life instruments. MIC Paper, 2. https://www.aqol.com.au/papers/researchpaper78.pdf. Accessed 12 Sept 2018.
- 52.Gray, A., Clarke, P., & Rivero-Arias, O. (2004). Estimating the association between SF-36 responses and EQ-5D utility values by direct mapping. In Health Economists Studying Group Meeting (HESG), Paris.Google Scholar
- 56.Dolan, P., Gudex, C., Kind, P., & Williams, A. (1995). A social tariff for EuroQol: Results from a UK general population survey. York: Centre for Health Economics University of York.Google Scholar
- 57.Longworth, L., Young, T., Ratcliffe, J., Bryan, S., & Buxton, M. (2001) Economic evaluation of the Transplantation Programme in England and Wales: An assessment of the costs of liver transplantation. Report to the Department of Health.Google Scholar