COMPARING THE TIME TRADEOFF (TTO), THE VISUAL ANALOGUE SCALE (VAS) AND THE EQ-5D VALUE-SETS IN PATIENTS TREATED WITH PAINFUL DIABETIC PERIPHERAL NEUROPATHY (PDPN) OR POST-HERPETIC NEURALGIA (PHN)

Author(s)

Gu NY1, Bell C2, Botteman M1, Van Hout BA31Pharmerit North America, LLC, Bethesda, MD, USA, 2GlaxoSmithBell, Research Triangle Park, NC, USA, 3University of Sheffield, Sheffield, United Kingdom

OBJECTIVES: To compare value sets derived from EQ-5D US tariffs and VAS and TTO in individuals with chronic pDPN/PHN. METHODS: This analysis was conducted using baseline responses from 3 longitudinal surveys of adults with ≥3 months of pDPN/PHN who were receiving pain medications. Of them, 2719 completed the EQ-5D and VAS and, 2109 completed TTOs. Three value-sets were derived using: the EQ-5D classifier (US-value-set), VAS, and TTO, which elicits patient willingness-to-trade time for reduced pain. Generalized linear models were used to compare the covariate-adjusted values, adjusting for age, income, overall pain quality, and pain severity (PS) using numerical rating scale ranging from 0 ("no pain") to 10 ("pain as bad as you can imagine"). Derived values were compared along PS, across all respondents and by subgroups according to degrees of social/psychological difficulties due to pain. RESULTS: Mean respondent age was 55.48 (±10.65) years and 58.73% reported having a PS≥6. Due to pain, 84% reported feeling older, 60.30% reported not feeling like going out and 60.29% wanted to be left alone. Mean values for EQ-5D, VAS and TTO were 0.594 (±0.215), 0.482 (±0.231) and -6.010 (±17.573), respectively. Mean covariate-adjusted values were 0.586 (±0.128), 0.471 (±0.075) and -6.156 (±4.151), respectively. All values decreased monotonically as PS increased. This monotonic relationship was strongest for TTO (resulting in a value of –11.98 at PS=10 after covariate adjustment), followed by the EQ-5D, and VAS (p<0.001). Similar results were found in stratified groups, especially in those with greater pDPN/PHN-related social/psychological difficulties compared to other patients (p<0.05). CONCLUSIONS: All three value-sets show scores significantly related to PS. Findings suggest that value-sets with lower-end constrains (VAS, EQ-5D) are likely to underestimate the true value of preventing pain and may not lead to correct prioritization when considering health states that involve moderate to severe pain.

Conference/Value in Health Info

2010-05, ISPOR 2010, Atlanta, GA, USA

Value in Health, Vol. 13, No. 3 (May 2010)

Code

PSY37

Topic

Patient-Centered Research

Topic Subcategory

Health State Utilities

Disease

Systemic Disorders/Conditions

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