OBJECTIVES: There is increasing interest in the integration of quantitative evidence from patient preference studies into HTA decision-making with a question being how this can best be achieved. We generated a health utility score for patients with COPD and considered its use within HTAs.

METHODS: Based on prior qualitative research, six symptoms were identified as important to COPD patients: shortness of breath, exacerbations, chronic cough, mucus secretion, sleep disturbance and urinary incontinence. A Discrete Choice Experiment (DCE) based on these six symptoms was employed with 1050 COPD patients from 5 countries (US, UK, France, Australia, Japan). The random parameter logit regression technique was used to estimate utility scores for all COPD health states. The relationship between patients’ COPD health utility score, self-perceived severity of their COPD and EQ-5D-3L utility score was assessed, with data stratified according to patient COPD disease severity and comorbidity subgroups.

RESULTS: The COPD health utility model had face validity, with utility scores negatively correlated with patients’ self-perceived COPD severity. Correlation between the COPD health utility scores and EQ-5D-3L values was only moderate (Spearman correlation, 0.52). This was largely explained by patients with EQ-5D-3L scores <0 exhibiting a range of comorbidities beyond their COPD which impacted their EQ-5D-3L scores, whereas the COPD health utility score was impacted less by the comorbid conditions.

CONCLUSIONS: A disease-focused measure of utility offers benefit in clinical trials of new therapies and in generating utility data in support of HTA submissions. Our COPD utility measure, derived from the DCE, provides a patient-centered health utility score, which is more sensitive to the COPD health of the individual and less sensitive to comorbidities. The instrument should be considered alongside more generic instruments for use when valuing new COPD therapies and using utility data in submissions to licensing and reimbursement agencies.