Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 7/2009

01-07-2009 | ORIGINAL PAPER

Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures

Authors: Rachel Mann, MSc, Prof. Simon Gilbody, DPhil, MRCPsych, Prof. David Richards, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 7/2009

Login to get access

Abstract

Background

Generic health preference measures that capture quality of life improvements in depression are important for economic analysis of new technologies.

Aim

To compare two widely used preference measures, the EQ-5D and SF-6D, in terms of their dimensions and health utility values.

Method

EQ-5D and SF-6D data collected from 114 patients with depression, who participated in a cluster, randomised controlled trial to evaluate a collaborative care intervention in UK, primary care practices. Utilities were examined across the whole sample and by level of depression severity using the PHQ-9.

Results

Depression was associated with disutility at baseline. At 3 month follow-up mean utility increased 0.147 for EQ-5D and 0.082 for SF-6D. Health gains were observed in patients in remission from depression and those with the mildest level of depression severity.

Conclusions

Both generic preference measures were sensitive to health gains in depression within a relatively short follow-up period; larger health gain was observed for the EQ-5D.
Appendix
Available only for authorised users
Literature
1.
go back to reference Brazier J, Deverill M, Green C, Harper R, Booth A (1999) A review of the use of health status measures in economic evaluation. Health Technol Assess 3:1–164 Brazier J, Deverill M, Green C, Harper R, Booth A (1999) A review of the use of health status measures in economic evaluation. Health Technol Assess 3:1–164
2.
go back to reference Brazier J, Roberts J, Deverill M (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21:271–292PubMedCrossRef Brazier J, Roberts J, Deverill M (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21:271–292PubMedCrossRef
3.
go back to reference Brazier JE, Akehurst R, Brennan A, Dolan P, Claxton K, McCabe C, Sculpher M, Tsuchyia A (2005) Should patients have a greater role in valuing health states? Appl Health Econ Health Policy 4(4):201–208PubMedCrossRef Brazier JE, Akehurst R, Brennan A, Dolan P, Claxton K, McCabe C, Sculpher M, Tsuchyia A (2005) Should patients have a greater role in valuing health states? Appl Health Econ Health Policy 4(4):201–208PubMedCrossRef
4.
go back to reference Brazier JE, Ratcliffe J, Tsuchiya A, Salomon J (2007) Measuring and valuing health benefits for economic evaluation. Oxford University Press, Oxford Brazier JE, Ratcliffe J, Tsuchiya A, Salomon J (2007) Measuring and valuing health benefits for economic evaluation. Oxford University Press, Oxford
5.
go back to reference Brazier JE, Roberts J, Tsuchiya A, Busschbach J (2004) A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 13:873–884PubMedCrossRef Brazier JE, Roberts J, Tsuchiya A, Busschbach J (2004) A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 13:873–884PubMedCrossRef
6.
go back to reference CCOHTA (1997) Guidelines for the economic evaluation of pharmaceuticals. Canadian Coordinating Office for Health Technology Assessment, Ottawa CCOHTA (1997) Guidelines for the economic evaluation of pharmaceuticals. Canadian Coordinating Office for Health Technology Assessment, Ottawa
7.
go back to reference Donaldson C, Currie G, Mitton C (2002) Cost effectiveness analysis in health care: contraindications. BMJ 325:891–894PubMedCrossRef Donaldson C, Currie G, Mitton C (2002) Cost effectiveness analysis in health care: contraindications. BMJ 325:891–894PubMedCrossRef
8.
go back to reference First M, Spitzer R, Gibbon M, Williams J (1996) Structured clinical interview schedule for DSM-IV axis/disorders, Clinical Version, (SCID-CV). American Psychiatric Press, Washington DC First M, Spitzer R, Gibbon M, Williams J (1996) Structured clinical interview schedule for DSM-IV axis/disorders, Clinical Version, (SCID-CV). American Psychiatric Press, Washington DC
9.
go back to reference Gilbody S, Richards D, Barkham M (2007) Diagnosing depression in primary care using self-completed instruments: UK validation of PHQ-9 and CORE-OM. Br J Gen Pract 57:650–652PubMed Gilbody S, Richards D, Barkham M (2007) Diagnosing depression in primary care using self-completed instruments: UK validation of PHQ-9 and CORE-OM. Br J Gen Pract 57:650–652PubMed
10.
go back to reference Gilbody S, Richards D, Brearly S, Hewitt C (2007) Screening for depression in medical settings with the patient health questionnaire (PHQ): a diagnostic meta-analysis. J Gener Int Med (in press) Gilbody S, Richards D, Brearly S, Hewitt C (2007) Screening for depression in medical settings with the patient health questionnaire (PHQ): a diagnostic meta-analysis. J Gener Int Med (in press)
11.
go back to reference Gold MR (1996) Cost-effectiveness in health and medicine. Oxford University Press, New York Gold MR (1996) Cost-effectiveness in health and medicine. Oxford University Press, New York
12.
go back to reference Gunther OH, Roick C, Angermeyer MC, Konig H-H (2008) The responsiveness of EQ-5D utility scores in patients with depression: a comparison with instruments measuring quality of life, psychopathology and social functioning. J Affect Disord (in press) Gunther OH, Roick C, Angermeyer MC, Konig H-H (2008) The responsiveness of EQ-5D utility scores in patients with depression: a comparison with instruments measuring quality of life, psychopathology and social functioning. J Affect Disord (in press)
13.
go back to reference Kaltenthaler E, Brazier J, De Nigris E, Tumur I, Ferriter M, Beverley C, Parry G, Rooney G, Sutcliffe P (2006) Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technol Assess 10:iii, xi-xiv, 1–168PubMed Kaltenthaler E, Brazier J, De Nigris E, Tumur I, Ferriter M, Beverley C, Parry G, Rooney G, Sutcliffe P (2006) Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technol Assess 10:iii, xi-xiv, 1–168PubMed
14.
go back to reference Kroenke K, Spitzer R (2002) The PHQ-9: a new depression and diagnostic severity measure. Psychiatric Ann 32:509–521 Kroenke K, Spitzer R (2002) The PHQ-9: a new depression and diagnostic severity measure. Psychiatric Ann 32:509–521
15.
go back to reference Lamers LM, Bouwmans C, van Straten A, Donker M, Hakkaart L (2006) Comparison of EQ-5D and SF-6D utilities in mental health patients. Health Econ 15:1229–1236PubMedCrossRef Lamers LM, Bouwmans C, van Straten A, Donker M, Hakkaart L (2006) Comparison of EQ-5D and SF-6D utilities in mental health patients. Health Econ 15:1229–1236PubMedCrossRef
17.
go back to reference Longworth L, Bryan S (2003) An emprical comparison of EQ-5D and SF-6D in liver transplant patients. Health Econ 12:1061–1067PubMedCrossRef Longworth L, Bryan S (2003) An emprical comparison of EQ-5D and SF-6D in liver transplant patients. Health Econ 12:1061–1067PubMedCrossRef
18.
go back to reference NICE (2007) Antenatal and postnatal mental health: clinical guideline (CG45). HMSO, London NICE (2007) Antenatal and postnatal mental health: clinical guideline (CG45). HMSO, London
19.
go back to reference NICE (2004) Depression: core interventions in the management of depression in primary care and secondary care. HMSO, London NICE (2004) Depression: core interventions in the management of depression in primary care and secondary care. HMSO, London
20.
go back to reference NICE (2004) Guide to the methods of technology appraisal. HMSO, London NICE (2004) Guide to the methods of technology appraisal. HMSO, London
21.
go back to reference Papakostas GI, Petersen T, Mahal Y, Mischoulon D, Nierenberg AA, Fava M (2004) Quality of life assessments in major depressive disorder: a review of the literature. General Hospital Psychiatry 26:13–17PubMedCrossRef Papakostas GI, Petersen T, Mahal Y, Mischoulon D, Nierenberg AA, Fava M (2004) Quality of life assessments in major depressive disorder: a review of the literature. General Hospital Psychiatry 26:13–17PubMedCrossRef
22.
go back to reference Peveler R, Kendrick T, Buxton M, Longworth L, Baldwin D, Moore M, Chatwin J, Goddard J, Thornett A, Smith H, Campbell M, Thompson C (2005) A randomised controlled trial to compare the cost-effectiveness of tricyclic antidepressants, selective serotonin reuptake inhibitors and lofepramine. Health Technol Assess 9:1–134PubMed Peveler R, Kendrick T, Buxton M, Longworth L, Baldwin D, Moore M, Chatwin J, Goddard J, Thornett A, Smith H, Campbell M, Thompson C (2005) A randomised controlled trial to compare the cost-effectiveness of tricyclic antidepressants, selective serotonin reuptake inhibitors and lofepramine. Health Technol Assess 9:1–134PubMed
23.
go back to reference Rawlins MD (2004) NICE work—providing guidance to the British National Health Service. N Engl J Med 351:1383–1385PubMedCrossRef Rawlins MD (2004) NICE work—providing guidance to the British National Health Service. N Engl J Med 351:1383–1385PubMedCrossRef
24.
go back to reference Rawlins MD, Culyer AJ (2004) National Institute for clinical excellence and its value judgments. BMJ 329:224–227PubMedCrossRef Rawlins MD, Culyer AJ (2004) National Institute for clinical excellence and its value judgments. BMJ 329:224–227PubMedCrossRef
25.
go back to reference Revicki DA, Wood M (1998) Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications. J Affect Disord 48:25–36PubMedCrossRef Revicki DA, Wood M (1998) Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications. J Affect Disord 48:25–36PubMedCrossRef
26.
go back to reference Richards D, Lovell K, Gilbody S, Gask L, Torgerson D, Barkham M, Bland M, Bower P, Lankshear A, Simpson A, Fletcher J, Escott D, Henessey S, Richardson R (2007) Collaborative care for depression in UK primary care: a randomized controlled trial. Psychol Med (in press) Richards D, Lovell K, Gilbody S, Gask L, Torgerson D, Barkham M, Bland M, Bower P, Lankshear A, Simpson A, Fletcher J, Escott D, Henessey S, Richardson R (2007) Collaborative care for depression in UK primary care: a randomized controlled trial. Psychol Med (in press)
27.
go back to reference Sapin C, Fantino B, Nowicki M-L, Kind P (2004) Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health Qual Life Outcomes 2:20PubMedCrossRef Sapin C, Fantino B, Nowicki M-L, Kind P (2004) Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health Qual Life Outcomes 2:20PubMedCrossRef
28.
go back to reference Donald Sherbourne C, Unutzer J, Schoenbaum M, Duan N, Lenert LA, Sturm R, Wells KB (2001) Can utility-weighted health-related quality-of-life estimates capture health effects of quality improvement for depression? Med Care 39:1246–1259PubMedCrossRef Donald Sherbourne C, Unutzer J, Schoenbaum M, Duan N, Lenert LA, Sturm R, Wells KB (2001) Can utility-weighted health-related quality-of-life estimates capture health effects of quality improvement for depression? Med Care 39:1246–1259PubMedCrossRef
29.
go back to reference Sobocki P, Ekman M, Agren H, Krakau I, Runeson B, Martensson B, Jonsson B (2007) Health-related quality of life measured with EQ-5D in patients treated for depression in primary care. Value Health 10:153–160PubMedCrossRef Sobocki P, Ekman M, Agren H, Krakau I, Runeson B, Martensson B, Jonsson B (2007) Health-related quality of life measured with EQ-5D in patients treated for depression in primary care. Value Health 10:153–160PubMedCrossRef
30.
go back to reference SPSS (2005) SPSS Base 14.0 User’s Guide. SPSS Inc, Chicago SPSS (2005) SPSS Base 14.0 User’s Guide. SPSS Inc, Chicago
31.
go back to reference The EuroQol Group (1990) EuroQol-a new facility for the measurement of health related quality of life. The EuroQol Group. Health Policy 16:199–208CrossRef The EuroQol Group (1990) EuroQol-a new facility for the measurement of health related quality of life. The EuroQol Group. Health Policy 16:199–208CrossRef
32.
go back to reference Thomas CM, Morris S (2003) Cost of depression among adults in England in 2000. Br J Psychiatry 183:514–519PubMedCrossRef Thomas CM, Morris S (2003) Cost of depression among adults in England in 2000. Br J Psychiatry 183:514–519PubMedCrossRef
33.
go back to reference Ware JE, Gandek B, Kosinski M, Snow KK (1993) SF-36 health survey: manual and interpretation guide. The Health Institute New England Medical Center, Boston Ware JE, Gandek B, Kosinski M, Snow KK (1993) SF-36 health survey: manual and interpretation guide. The Health Institute New England Medical Center, Boston
34.
go back to reference Williams A (1995) The measurement and valuation of health: a chronicle. discussion paper 136. In: Centre for health economics. York Health Economics Consortium, The University of York Williams A (1995) The measurement and valuation of health: a chronicle. discussion paper 136. In: Centre for health economics. York Health Economics Consortium, The University of York
35.
go back to reference World Health Organisation (2001) The World Health Report 2001: mental health: new understanding: new hope. World Health Organisation, Geneva World Health Organisation (2001) The World Health Report 2001: mental health: new understanding: new hope. World Health Organisation, Geneva
Metadata
Title
Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures
Authors
Rachel Mann, MSc
Prof. Simon Gilbody, DPhil, MRCPsych
Prof. David Richards, PhD
Publication date
01-07-2009
Publisher
Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 7/2009
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-008-0463-5

Other articles of this Issue 7/2009

Social Psychiatry and Psychiatric Epidemiology 7/2009 Go to the issue