Health-state utility estimates for health technology assessment: a review of the manufacturers' submissions to the French National Authority for Health

Expert Rev Pharmacoecon Outcomes Res. 2017 Oct;17(5):489-494. doi: 10.1080/14737167.2017.1289088. Epub 2017 Feb 8.

Abstract

Background: Our aim was to review the selection and methods used for deriving health state utility (HSU) estimates included in the cost-utility analyses (CUA) submitted by manufacturers to the National Authority for Health (HAS) during the first 2 years after the introduction of the economic evaluation for price setting in France.

Methods: We reviewed all manufacturers' submissions that included a CUA and were assessed by HAS by the end of October 2015 (N = 34). We reviewed the identification, selection, and methods used to estimate HSU and compared them with those recommended by HAS.

Results: A literature review to identify HSU was reported in only 13 (38%) submissions. The instruments for describing HSU were a preference-based generic instrument in 20 (59%) submissions; vignettes in five (15%); a condition-specific instrument in three (9%); and a combination of instruments in six (18%). The valuation perspective was the general population in 26 (76%) submissions; in only nine (26%) submissions, the valuation set was derived from the French general population.

Conclusions: We identified numerous concerns in the selection, valuation and use of HSU, as well as a frequent lack of clarity in the methods used. Most submissions (79%) included HSU that did not meet HAS recommendations.

Keywords: Economic evaluation; France; health-related quality of life; health-state utility; quality-adjusted life-years.

MeSH terms

  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Drug Industry / economics
  • France
  • Health Status*
  • Humans
  • Quality-Adjusted Life Years*
  • Technology Assessment, Biomedical / economics
  • Technology Assessment, Biomedical / methods*