OBJECTIVES: The choice of health state utility values (HSUVs) can significantly influence cost utility analysis (CUA) results, particularly in older adults with infections whose HSUVs might be heterogeneous due to age, comorbidity, or frailty levels. However, despite the importance, the rigorous selection of HSUVs is often overlooked, leading to potential misleading outcomes. This study aims to analyze the methods used to elicit HSUVs in CUAs of infectious diseases in older adults.

METHODS: A comprehensive literature review was conducted on PubMed in January 2023 to identify published CUAs of infectious diseases in older adults. These studies underwent critical appraisal independently by two reviewers using the modified checklist developed by Nerich et al. to evaluate the elicitation methods of HSUVs.

RESULTS: (Preliminary) The review identified 113 CUAs, and a total of 60 studies have been analyzed. Out of these, 6 studies (10%) cited original health state utility studies, while 45 studies (75%) cited economic evaluations. Most studies did not provide an explanation for their choice or description of the techniques used to elicit HSUVs. Twenty-four studies (40%) used HSUVs that were appropriate in terms of comparability between populations and countries. In 44 studies (73%), outdated references (more than 10 years older than the CUA) were used. Inconsistencies between cited HSUVs and the references were observed in 12 studies. Only 5 studies (8%) discussed limitations regarding the elicitation of HSUVs.

CONCLUSIONS: This study highlights the poor practices in the elicitation of HSUVs in CUAs of interventions against infectious diseases in older adults. It is crucial to encourage health economists to adopt a systematic approach in choosing and eliciting HSUVs for accurate health economic evaluations. Additionally, prioritizing data collection of HSUVs is necessary to support future CUAs.