Abstract
BACKGROUND: Cost-effectiveness analysis (CEA) using quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs) to measure health benefits requires health-related quality of life weights. The lack of standardization in valuation weights undermines comparability between CEAs.
OBJECTIVE: To describe how utility weights and disability weights have been used in the context of QALY and DALY-based CEAs of pediatric vaccines for infectious diseases and assess the comparability between weights.
METHODS: A systematic review was conducted of CEAs of pediatric vaccines for 16 infectious diseases, published between January 2013 and December 2020 and using QALYs or DALYs as outcome measure. Data on values and sources of weights for the estimation of QALYs and DALYs were extracted from studies and compared across similar health states. Reporting was conducted according to the PRISMA statement.
RESULTS: Out of 2154 articles identified, 216 CEAs met our inclusion criteria. Of the included studies, 157 used utility weights and 59 used disability weights in their valuation of health states. In QALY studies, the source, background, who's preferences (adults'/children's) were applied and adjustments made to utility weights were poorly reported. In DALY studies, the Global Burden of Disease study was most often referenced. Valuation weights for similar health states varied within QALY studies and between DALY and QALY studies, but no systematic differences were identified.
CONCLUSIONS: This review identified considerable gaps in the way valuation weights are used and reported on in CEA. The non-standardized use of weights may lead to different conclusions about cost-effectiveness of vaccines and policy decisions.
| Original language | English |
|---|---|
| Pages (from-to) | 1098-1106 |
| Number of pages | 9 |
| Journal | Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research |
| Volume | 26 |
| Issue number | 7 |
| Early online date | 24 Mar 2023 |
| DOIs | |
| Publication status | Published - Jul 2023 |
Bibliographical note
Funding Information:Funding/Support: Neppelenbroek received support from the Utrecht University U/Select scholarship, the Hendrik Muller Fund, Van Renswoude Fund, K.F. Hein Fund, and the Jo Kolk Fund. All funding was unrestricted. Dr Carvalho was supported by the University of Melbourne McKenzie Postdoctoral Fellowship Award and the University of Melbourne Faculty of Medicine, Dentistry and Health Sciences Research Fellowship.
Funding Information:
Funding/Support: Neppelenbroek received support from the Utrecht University U/Select scholarship, the Hendrik Muller Fund, Van Renswoude Fund, K.F. Hein Fund, and the Jo Kolk Fund. All funding was unrestricted. Dr Carvalho was supported by the University of Melbourne McKenzie Postdoctoral Fellowship Award and the University of Melbourne Faculty of Medicine , Dentistry and Health Sciences Research Fellowship.
Publisher Copyright:
© 2023
Keywords
- health-related quality of life
- infectious diseases
- literature review
- pediatric
- vaccine preventable
