OBJECTIVES: Evaluating the relevance of published health utilities to the context of a cost-utility analysis (CUA) is an essential - yet often overlooked - task and is largely left to the discretion of the investigator. The objective of this study was to provide guidance on this process by developing the Health utility Application Tool (HAT).

METHODS: First, we conducted a scoping review of appraisal tools intended for use with economic evaluations or health utility studies to identify candidate items. Second, we conducted semi-structured telephone interviews with Canadian stakeholders from reimbursement bodies, academia, and the pharmaceutical industry. These interviews were designed to gather participants’ practices for selecting published health utilities for CUAs and their opinions about the relevance of the candidate items. Finally, we conducted an online survey with international members of the general health economics and outcomes research community to gather opinions on key concepts to consider when applying the health utility literature to CUAs.

RESULTS: Based on the themes emerging from the review, interviews, and online questionnaire, the HAT includes questions to prompt investigators to consider the following constructs: similarity of the clinical condition in the health utility study and the CUA; similarity of health utility study participant demographics and the demographics of the CUA’s target population; similarity of the health state descriptions in the health utility study and the CUA; and use of health utility values in the CUA as reported in the health utility study. Consideration of good reporting standards identified additional important items: means by which the health utility study was identified; type of respondents; study design; and the measure used to collect health utility estimates.

CONCLUSION: The HAT is intended to guide the evaluation of the applicability of published health utilities for a CUA, thus promoting transparency and accountability in the selection of model inputs.