OBJECTIVES : The utility score is an important parameter for calculating quality-adjusted life years which is based on individual preference. Whether the utility values from appropriate sociocultural background people were used would affects the evaluation results. This study was to evaluate the sources of utility value in cost-utility analyses conducted in China.

METHODS : A systematic literature review was performed by searching PubMed, CNKI, Wan-fang and CQVIP databases, to identify relevant articles in both Chinese and English published up to July 2019. The use of utility values was analyzed.

RESULTS : Of the 20,774 retrieved studies, 442 were finally included for data extraction and analyses. Among those studies reported the utility values, the diseases were focused on cardiovascular and cerebrovascular diseases, hepatitis, and diabetes and its complications. The paper numbers of utility values that were derived from references, direct measurement and subjective assumption was 315, 82, and 24, respectively.

Among these literatures where the state utility value was derived from references, only 23.5% used the value based on Chinese population (all health state utility value based on Chinese population in paper accounted for 12.7%, and a part of health state utility value was 10.8%.). 77% of literatures which the value was based on Chinese population were published since 2015, The key diseases were focused on hepatitis, non-small cell lung cancer and breast cancer. Among these literatures where the utility value was direct measured, most use of the instrument was inappropriate even though these values were from Chinese population.

CONCLUSIONS : Most of the utility values in the cost-utility analyses in China were from foreign data, few of them were direct measured. Improving the understanding of utility, using own-country values was needed to meet the demands of cost-utility analyses for stakeholders.