This Article Full Text (PDF) All Versions of this Article: 0272989X07301822v1 27/3/327    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Noyes, K. Articles by Holloway, R. G. Search for Related Content PubMed PubMed Citation Articles by Noyes, K. Articles by Holloway, R. G. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB LEVODOPA Social Bookmarking                         What's this?

The Implications of Using US-Specific EQ-5D Preference Weights for Cost-Effectiveness Evaluation

Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York, katia_noyes{at}urmc.rochester.edu

Andrew W. Dick, PhD

Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York, The RAND Corporation, Pittsburgh, Pennsylvania

Robert G. Holloway, MD, MPH

Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, New York, Department of Neurology, University of Rochester School of Medicine, Rochester, New York

Objective. The objective of this study is to examine the effect of country-specific EQ-5D preference weights on the cost-effectiveness (CE) of initial pramipexole versus levodopa strategy in patients with Parkinson disease (PD). Methods. A total of 301 subjects with PD were randomized to initial pramipexole or levodopa and followed every 3 months over a 4-year period. Subjects' health-related quality of life (HRQOL) was measured using EQ-5D, and their health preferences were calculated using both the UK and US sets of weights. The effectiveness of pramipexole was defined as the additional quality-adjusted life-years (QALY) gained compared to levodopa and was estimated as the area between the treatment-specific HRQOL profiles adjusted for baseline difference. Results. Using the original UK weights, the incremental effectiveness was 0.155 QALYs, which resulted in the incremental CE ratio (ICER) of $42,989/QALY and a probability that pramipexole was cost-effective relative to levodopa of 0.57, 0.77, and 0.82 when a QALY was valued at $50,000, $100,000, and $150,000, respectively. Using the US-specific weights resulted in lower incremental effectiveness (0.062 QALYs), higher ICER ($108,498/QALY), and a lower probability that pramipexole was cost-effective compared to levodopa at any valuation of QALY (0.23 for $50,000, 0.48 for $100,000, and 0.58 for $150,000). Conclusions. Country-specific preference weights in clinical-economic trials might have important effects on estimates of incremental cost-effectiveness. Using US preference weights rather than UK preference weights reduced the probability that pramipexole was cost-effective compared to levodopa.

Key Words: Key words: Parkinson disease • EQ-5D • quality of life • cost-effectiveness • pramipexole • levodopa. (Med Decis Making 2007;27:327—334)

This version was published on May 1, 2007

Medical Decision Making, Vol. 27, No. 3, 327-334 (2007)
DOI: 10.1177/0272989X07301822


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				W. Miller The Significance of Using US-Valued EQ-5D Health States for Comparative Effectiveness and Cost-Effectiveness Studies in US Populations Med Decis Making, May 1, 2007; 27(3): 229 - 230. [PDF]

				L. B. Russell Is All Cost-Effectiveness Analysis Local? Med Decis Making, May 1, 2007; 27(3): 231 - 232. [PDF]