Presentation (CTI)

OBJECTIVES: To describe the assessment of health state utilities derived from vignette studies by Swedish, Danish, and Norwegian health technology assessment (HTA) agencies in economic analyses.
METHODS: A key word search was conducted in the NMAi database, which includes documents from Nordic HTA-bodies, to identify reimbursement assessment reports issued by TLV, DMC, and NoMA between 2016 and 2025. Search hits were assessed for the use of vignette-derived health state utilities. Metadata on drug name, indication, reimbursement or funding status, and other relevant variables were collected and analysed using descriptive statistics.
RESULTS: The search resulted in 73 documents. A total of 41 assessments of 29 drugs contained vignette-derived utilities (n=13, TLV; n=18, DMC; n=10, NoMA). Slightly more than half of the drugs assessed were classified as orphan drugs by the European Medicines Agency (EMA).Vignette-derived utilities were used in the authorities’ base cases in 58% of DMC assessments, 60% of NoMA assessments, and 38% of TLV assessments. The main reason for the authorities to not use the vignette-derived utilities were the availability of alternatives, such as trial-based utilities.
CONCLUSIONS: Vignette-derived health state utilities have been used for decision-making in Scandinavia, however, authorities view them as uncertain and prefer more conventional collections, such as trial-based utilities. The majority of the assessed drugs that included vignette-derived utilities were orphan drugs. This likely reflects the challenges of collecting patient-reported utility data in rare diseases, where small patient populations, disease severity, and logistical constraints often limit the feasibility of generating robust trial-based utility estimates.