OBJECTIVES: Geographic atrophy (GA) is an advanced form of dry age-related macular degeneration (AMD) which may severely impair central vision. There are no published utility values for the health-related quality of life (HRQoL) of GA patients. This study aimed to develop these data by implementing time-trade off (TTO) methodology.

METHODS: Qualitative research with GA patients and retinal specialists were undertaken to develop 5 vignette health states which reflected a range of condition severities, characterised by best-corrected visual acuity. Each health state was valued independently by 1005 members of the UK general public in an online TTO survey. A TTO asks individuals to choose between living a longer life in a state of impaired health and a shorter life in full health.

RESULTS: Base-case analysis was conducted on a subsample of 712 respondents who did not assign: i) all health states the same utility value and ii) a lower utility value to the most severe health state than the mildest health state. From the base-case analysis, the highest mean utility value was elicited for the mildest health state (>75 EDTRS letters; 0.85) and the lowest mean utility value was elicited for the most severe health state (<36 EDTRS letters; 0.14). All health states were valued better than dead with positive mean utility values. Subgroup and regression analyses demonstrated limited evidence of differences in utility values based on key characteristics.

CONCLUSIONS: This study is the first vignette study using the TTO approach to value condition-specific utilities for people living with GA. The mean health state utility values estimated in this study show a non-linear decrease in mean utility across health states, particularly toward the most severe states. Utility values generated from this study can be utilized for cost-effectiveness evaluations of new interventions for GA by Health Technology Assessment (HTA) agencies.