Do Public Preferences Matter? Health-Economic Evaluation of Antineoplastic Medication Considering EQ-5D Value Sets From Several Countries
Author(s)
Abeer A. Al Rabayah, MBA, MSc1, Khader Al-Habash, PharmD2, Razan Derar Sawalha, MSc(HealthEcon)2, Gaby Sroczynski, MPH, DrPH3, Beate Jahn, PhD3, Saad Jaddoua, BS, RPh2, Uwe Siebert, MPH, MSc, ScD, MD4.
1UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria; King Hussein Cancer Center, Amman, Jordan, 2King Hussein Cancer Center, Amman, Jordan, 3UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 4UMIT TIROL - University for Health Sciences and Technology; Harvard Chan School of Public Health, Hall in Tirol, Austria.
1UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria; King Hussein Cancer Center, Amman, Jordan, 2King Hussein Cancer Center, Amman, Jordan, 3UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 4UMIT TIROL - University for Health Sciences and Technology; Harvard Chan School of Public Health, Hall in Tirol, Austria.
OBJECTIVES: Cost-utility for health technology assessment is increasingly being used to inform decision-making on resource allocation in the Middle East and North Africa. This study aimed to assess the impact of the source of utility estimates on economic evaluation results.
METHODS: We developed a partitioned survival model with a five-year time horizon to assess the cost-utility of antineoplastic medication (Trifluridine/Tipiracil) compared with best supportive care (BSC) for treating metastatic colorectal cancer from the Jordanian payer's perspective. Utility inputs were based on EQ-5D-3L value sets from several countries (Tunisia, UK, USA, Sweden, Russia, China). Resource use was collected using a questionnaire distributed across clinical experts and data gathered from patients' electronic medical records. Costs were collected from the respective hospital's finance department, and the published medication list prices for the year 2024 were used. Both costs and outcomes were discounted using 3% annual discount rate. Uncertainty was assessed using deterministic and probabilistic sensitivity analyses. We conducted several scenarios to determine the impact of using value sets from different countries on the final incremental cost-utility ratios (ICUR). Using a threshold of 40,000-56,000 US$/QALY, we performed a threshold analysis to assess at what price the intervention is cost-effective.
RESULTS: Trifluridine/Tipiracil is associated with an increased benefit compared with BSC in all scenarios. The reported QALY gains ranged from 0.08 using the EQ-5D-3L value set from Sweden to 0.12 using the EQ-5D-3L value set from the UK. Using Jordanian patients' utilities calculated based on EQ-5D-3L value set from Jordan, Tunisia, UK, USA, Sweden, Russia, and China, resulted in ICURs of 112,578 US$/QALY, 116,837 US$/QALY, 91,489 US$/QALY, 106,709 US$/QALY, 130,573 US$/QALY, 123,449 US$/QALY, and 112,473 US$/QALY, respectively.
CONCLUSIONS: Health-state utilities elicited from different EQ-5D-3L value sets impact the ICUR, reimbursement decisions, and value-based prices. Therefore, careful, justified selection of value sets is recommended.
METHODS: We developed a partitioned survival model with a five-year time horizon to assess the cost-utility of antineoplastic medication (Trifluridine/Tipiracil) compared with best supportive care (BSC) for treating metastatic colorectal cancer from the Jordanian payer's perspective. Utility inputs were based on EQ-5D-3L value sets from several countries (Tunisia, UK, USA, Sweden, Russia, China). Resource use was collected using a questionnaire distributed across clinical experts and data gathered from patients' electronic medical records. Costs were collected from the respective hospital's finance department, and the published medication list prices for the year 2024 were used. Both costs and outcomes were discounted using 3% annual discount rate. Uncertainty was assessed using deterministic and probabilistic sensitivity analyses. We conducted several scenarios to determine the impact of using value sets from different countries on the final incremental cost-utility ratios (ICUR). Using a threshold of 40,000-56,000 US$/QALY, we performed a threshold analysis to assess at what price the intervention is cost-effective.
RESULTS: Trifluridine/Tipiracil is associated with an increased benefit compared with BSC in all scenarios. The reported QALY gains ranged from 0.08 using the EQ-5D-3L value set from Sweden to 0.12 using the EQ-5D-3L value set from the UK. Using Jordanian patients' utilities calculated based on EQ-5D-3L value set from Jordan, Tunisia, UK, USA, Sweden, Russia, and China, resulted in ICURs of 112,578 US$/QALY, 116,837 US$/QALY, 91,489 US$/QALY, 106,709 US$/QALY, 130,573 US$/QALY, 123,449 US$/QALY, and 112,473 US$/QALY, respectively.
CONCLUSIONS: Health-state utilities elicited from different EQ-5D-3L value sets impact the ICUR, reimbursement decisions, and value-based prices. Therefore, careful, justified selection of value sets is recommended.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE338
Topic
Economic Evaluation, Health Technology Assessment, Methodological & Statistical Research
Disease
Oncology