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Published in: The European Journal of Health Economics 1/2019

Open Access 01-06-2019 | Crohn's Disease | Original Paper

Patient and general population values for luminal and perianal fistulising Crohn’s disease health states

Authors: Fanni Rencz, Peep F. M. Stalmeier, Márta Péntek, Valentin Brodszky, Gábor Ruzsa, Lóránt Gönczi, Károly Palatka, László Herszényi, Eszter Schäfer, János Banai, Mariann Rutka, László Gulácsi, Peter L. Lakatos

Published in: The European Journal of Health Economics | Special Issue 1/2019

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Abstract

Background

In patients with Crohn’s disease (CD), luminal disease activity paralleled by perianal fistulas may seriously impair health-related quality of life (HRQoL). Health utility values are not available from patients with CD that reflect the health loss associated with both luminal and perianal CD.

Objective

To generate utilities for luminal and concomitant perianal fistulising CD health states directly from patients and from members of the general public.

Methods

A cross-sectional survey was undertaken enrolling CD patients and a convenience sample of members of the general population. Respondents were asked to evaluate four common CD heath states [severe luminal disease (sCD), mild luminal disease (mCD), severe luminal disease with active perianal fistulas (sPFCD), and mild luminal disease with active perianal fistulas (mPFCD)] by 10-year time trade-off (TTO). In addition, patients assessed their current HRQoL by the TTO method.

Results

Responses of 206 patients (40.8% with perianal fistulas) and 221 members of the general population were analysed. Mean ± SD utilities among patients for sPFCD, sCD, mPFCD and mCD states were 0.69 ± 0.33, 0.73 ± 0.31, 0.80 ± 0.29 and 0.87 ± 0.26. Corresponding values in the general public were: 0.59 ± 0.31, 0.65 ± 0.29, 0.80 ± 0.26 and 0.88 ± 0.25. Patients with active perianal fistulas, previous non-resection surgeries, and higher pain intensity scores valued their current health as worse (p < 0.05).

Conclusions

TTO is a feasible method to assess HRQoL in patients with perianal fistulising disease, often not captured by health status questionnaires. Utilities from this study are intended to support the optimization of treatment-related decision making in patients with luminal disease paralleled by active perianal fistulas.
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Metadata
Title
Patient and general population values for luminal and perianal fistulising Crohn’s disease health states
Authors
Fanni Rencz
Peep F. M. Stalmeier
Márta Péntek
Valentin Brodszky
Gábor Ruzsa
Lóránt Gönczi
Károly Palatka
László Herszényi
Eszter Schäfer
János Banai
Mariann Rutka
László Gulácsi
Peter L. Lakatos
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Keyword
Crohn's Disease
Published in
The European Journal of Health Economics / Issue Special Issue 1/2019
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-019-01065-y

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