Health state utility values measured using the EuroQol 5-dimensions questionnaire in adults with chronic hepatitis C: a systematic literature review and meta-analysis

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

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.

Funding

This study was funded by Gilead Sciences Europe Ltd.

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Correspondence to A. M. Buchanan-Hughes.

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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.

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Buchanan-Hughes, A.M., Buti, M., Hanman, K. et al. Health state utility values measured using the EuroQol 5-dimensions questionnaire in adults with chronic hepatitis C: a systematic literature review and meta-analysis. Qual Life Res 28, 297–319 (2019). https://doi.org/10.1007/s11136-018-1992-3

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Keywords

  • EQ-5D
  • HCV
  • Hepatitis C
  • QoL
  • Quality of life
  • Utility