Suzi Claflin1, Julie A Campbell2, Richard Norman3, Deborah F Mason4, Tomas Kalincik5,6, Steve Simpson-Yap7,8, Helmut Butzkueven9, William M Carroll10, Andrew J Palmer7,11, C Leigh Blizzard7, Ingrid van der Mei7, Glen J Henson7, Bruce V Taylor12. 1. Menzies Institute for Medical Research, University of Tasmania, Medical Science Precinct, 17 Liverpool Street, Hobart, TAS, 7000, Australia. Suzi.Claflin@utas.edu.au. 2. Menzies Institute for Medical Research, University of Tasmania, Medical Science Precinct, 17 Liverpool Street, Hobart, TAS, 7000, Australia. Julie.Campbell@utas.edu.au. 3. Curtin University, Perth, Australia. 4. New Zealand Brain Research Institute, Christchurch, New Zealand. 5. CORe The University of Melbourne, Melbourne, Australia. 6. Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia. 7. Menzies Institute for Medical Research, University of Tasmania, Medical Science Precinct, 17 Liverpool Street, Hobart, TAS, 7000, Australia. 8. Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. 9. Department of Neuroscience, Monash University, Melbourne, Australia. 10. Perron Institute, Nedlands, Australia. 11. Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia. 12. Menzies Institute for Medical Research, University of Tasmania, Medical Science Precinct, 17 Liverpool Street, Hobart, TAS, 7000, Australia. Bruce.Taylor@utas.edu.au.
Abstract
BACKGROUND: Health state utilities (HSU) are a health-related quality-of-life (HRQoL) input for cost-utility analyses used for resource allocation decisions, including medication reimbursement. New Zealand (NZ) guidelines recommend the EQ-5D instruments; however, the EQ-5D-5L may not sufficiently capture psychosocial health. We evaluated HRQoL among people with multiple sclerosis (MS) in NZ using the EQ-5D-5L and assessed the instrument's discriminatory sensitivity for a NZ MS cohort. METHODS: Participants were recruited from the NZ MS Prevalence Study. Participants self-completed a 45-min online survey that included the EQ-5D-5L/EQ-VAS. Disability severity was classified using the Expanded Disability Status Scale (EDSS) to categorise participant disability as mild (EDSS: 0-3.5), moderate (EDSS: 4.0-6.0) and severe (EDSS: 6.5-9.5). Anxiety/depression were also measured using the Hospital Anxiety and Depression Score (HADS). In the absence of an EQ-5D-5L NZ tariff, HSUs were derived using an Australian tariff. We evaluated associations between HSUs and participant characteristics with linear regression models. RESULTS: 254 participants entered the study. Mean age was 55.2 years, 79.5% were female. Mean (SD) EQ-5D-5L HSU was 0.58 (0.33). Mean (SD) HSUs for disability categories were: mild 0.80 ± 0.17, moderate 0.57 ± 0.21 and severe 0.14 ± 0.32. Twelve percent reported HSU = 1.0 (i.e., no problems in any domain). Participants who had never used a disease-modifying therapy reported a lower mean HSU. Multivariable modelling found that the HADS anxiety score was not associated with EQ-5D-5L. CONCLUSIONS: HRQoL for people with MS in NZ was lower than comparable countries, including Australia. We suggest a comparison with other generic tools that may have improved sensitivity to mental health.
BACKGROUND: Health state utilities (HSU) are a health-related quality-of-life (HRQoL) input for cost-utility analyses used for resource allocation decisions, including medication reimbursement. New Zealand (NZ) guidelines recommend the EQ-5D instruments; however, the EQ-5D-5L may not sufficiently capture psychosocial health. We evaluated HRQoL among people with multiple sclerosis (MS) in NZ using the EQ-5D-5L and assessed the instrument's discriminatory sensitivity for a NZ MS cohort. METHODS: Participants were recruited from the NZ MS Prevalence Study. Participants self-completed a 45-min online survey that included the EQ-5D-5L/EQ-VAS. Disability severity was classified using the Expanded Disability Status Scale (EDSS) to categorise participant disability as mild (EDSS: 0-3.5), moderate (EDSS: 4.0-6.0) and severe (EDSS: 6.5-9.5). Anxiety/depression were also measured using the Hospital Anxiety and Depression Score (HADS). In the absence of an EQ-5D-5L NZ tariff, HSUs were derived using an Australian tariff. We evaluated associations between HSUs and participant characteristics with linear regression models. RESULTS: 254 participants entered the study. Mean age was 55.2 years, 79.5% were female. Mean (SD) EQ-5D-5L HSU was 0.58 (0.33). Mean (SD) HSUs for disability categories were: mild 0.80 ± 0.17, moderate 0.57 ± 0.21 and severe 0.14 ± 0.32. Twelve percent reported HSU = 1.0 (i.e., no problems in any domain). Participants who had never used a disease-modifying therapy reported a lower mean HSU. Multivariable modelling found that the HADS anxiety score was not associated with EQ-5D-5L. CONCLUSIONS: HRQoL for people with MS in NZ was lower than comparable countries, including Australia. We suggest a comparison with other generic tools that may have improved sensitivity to mental health.
Authors: Julie A Campbell; Steve Simpson; Hasnat Ahmad; Bruce V Taylor; Ingrid van der Mei; Andrew J Palmer Journal: Mult Scler Date: 2019-07-26 Impact factor: 6.312