HEALTH UTILITY VALUES MEASURED BY EQ-5D IN PATIENTS WITH PARKINSON'S DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Author(s)
SOOBIN JANG, PhD1, Mi Mi Ko, PhD2, PYUNG-WHA KIM, M.S.2, Chunhoo Cheon, Ph.D.3, Hyein Jeong, Ph.D.3, Soo-Hyun Sung, Ph.D.4.
1Assistant Professor, Kyung Hee University, Seoul, Korea, Republic of, 2Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of, 4Wonkwang University, Iksan, Korea, Republic of.
1Assistant Professor, Kyung Hee University, Seoul, Korea, Republic of, 2Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of, 4Wonkwang University, Iksan, Korea, Republic of.
OBJECTIVES: Parkinson's disease (PD) imposes a progressive and substantial burden on health-related quality of life (HRQoL), yet reliable utility estimates for economic evaluations remain fragmented across heterogeneous study populations. Health utility values are essential inputs for cost-utility analyses (CUAs) and quality-adjusted life year (QALY) calculations, which are critical for evidence-based resource allocation in PD care. This study aimed to systematically review and meta-analyze EQ-5D utility values in patients with PD, with stratification by disease severity, geographic region, and study design.
METHODS: Six databases (MEDLINE, EMBASE, CENTRAL, Web of Science, CINAHL, and KoreaMed) were searched up to June 2025. Studies reporting EQ-5D utility scores in patients with idiopathic PD were eligible. Case-control studies were excluded to ensure estimates reflected PD patients exclusively. A random-effects DerSimonian-Laird model was used to pool estimates. Subgroup analyses were performed by geographic region, study design, and Hoehn and Yahr (H&Y) stage.
RESULTS: Forty-five studies were included in qualitative synthesis, of which 35 (N=10,797) were included in meta-analysis. The overall pooled baseline EQ-5D utility was 0.67 (95% CI: 0.64-0.70; I²=98.4%), reflecting substantial heterogeneity. Regional variation was substantial: America 0.745, Australia 0.715, Asia 0.697, Europe 0.594. By study design, RCT-derived estimates (0.747) markedly exceeded observational (0.621), cross-sectional (0.607), and cohort (0.518) estimates, reflecting patient selection bias in trial settings and real-world disease burden in observational data. Most critically, a steep severity gradient was observed across H&Y stages: 0.742 (stage 1-2.5), 0.506 (stage 3), and 0.163 (stage 4-5), demonstrating profound HRQoL deterioration in advanced disease.
CONCLUSIONS: This review provides comprehensive, stage-specific and region-stratified EQ-5D utility estimates for PD. The H&Y stage-specific estimates serve as precise input parameters for Markov state-transition models, supporting robust CUAs and health technology assessments of PD interventions worldwide.
METHODS: Six databases (MEDLINE, EMBASE, CENTRAL, Web of Science, CINAHL, and KoreaMed) were searched up to June 2025. Studies reporting EQ-5D utility scores in patients with idiopathic PD were eligible. Case-control studies were excluded to ensure estimates reflected PD patients exclusively. A random-effects DerSimonian-Laird model was used to pool estimates. Subgroup analyses were performed by geographic region, study design, and Hoehn and Yahr (H&Y) stage.
RESULTS: Forty-five studies were included in qualitative synthesis, of which 35 (N=10,797) were included in meta-analysis. The overall pooled baseline EQ-5D utility was 0.67 (95% CI: 0.64-0.70; I²=98.4%), reflecting substantial heterogeneity. Regional variation was substantial: America 0.745, Australia 0.715, Asia 0.697, Europe 0.594. By study design, RCT-derived estimates (0.747) markedly exceeded observational (0.621), cross-sectional (0.607), and cohort (0.518) estimates, reflecting patient selection bias in trial settings and real-world disease burden in observational data. Most critically, a steep severity gradient was observed across H&Y stages: 0.742 (stage 1-2.5), 0.506 (stage 3), and 0.163 (stage 4-5), demonstrating profound HRQoL deterioration in advanced disease.
CONCLUSIONS: This review provides comprehensive, stage-specific and region-stratified EQ-5D utility estimates for PD. The H&Y stage-specific estimates serve as precise input parameters for Markov state-transition models, supporting robust CUAs and health technology assessments of PD interventions worldwide.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE206
Topic
Clinical Outcomes, Economic Evaluation, Patient-Centered Research
Disease
Neurological Disorders