OBJECTIVES: The objective of this review was to identify and assess the approaches used to measure and value change in HRQoL in trial-based economic evaluations of heart failure interventions which reported quality-adjusted life years (QALYs) as an outcome.

METHODS: Systemic review of trial-based cost-utility analyses of interventions used in heart failure, identified by searching three databases (PubMed, CINAHL, Cochrane).

RESULTS: Twenty studies reporting economic evaluations based on 18 individual trials were identified. Most studies (n=17) utilised generic preference-based measures to derive QALYs, commonly the EQ-5D-3L. Of these, 3 studies (from the same trial) used mapping from a condition-specific to a generic measure. The remaining 3 studies used patients’ direct evaluation of their own health or physician-reported outcomes to derive QALYs. Only 7 of the 20 studies reported significant incremental QALY gains. Most interventions were reported as being likely to be cost-effective at specified willingness to pay thresholds.

CONCLUSIONS: The substantial variation in the approach applied to derive QALYs in the measurement of and value attributed to HRQoL in heart failure requires further investigation as generic preference-based measures may not be sensitive to such changes. Heart failure condition-specific, preference-based measures may be more appropriate.