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The European Journal of Health Economics
Published in: The European Journal of Health Economics 7/2020

01-09-2020 | Original Paper

Measuring intangible cost-of-morbidity due to substance dependence: implications of using alternative preference-based instruments

Authors: Bruno Casal, Eva Rodríguez-Míguez, Berta Rivera

Published in: The European Journal of Health Economics | Issue 7/2020

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Abstract

Objective

Drug and/or alcohol dependence (DAD) generates substantial costs to society. One of the main consequences of DAD is its negative impact on health-related quality of life (HRQoL). The main objective of this study is to analyse the impact of using EQ-5D-5L, SF-6DSG (SF-6D using standard-gamble as the preference-eliciting method) and SF-6DPG (SF-6D using a paired-gamble method), to estimate the HRQoL burden, attributable to DAD, within the cost-of-illness framework.

Methods

A convenience sample of 109 patients with a diagnosis of substance use disorder was recruited. SF-6D and EQ-5D-5L were administered and then the utility scores were computed. The impact of employing different instruments to estimate the HRQoL burden was assessed by comparing the utility scores of patients and general population after controlling for sex and age through regression analysis. The analysis was reproduced for two subgroups of severity.

Results

All instruments detect that DAD significantly affects the HRQoL. However, the estimated impact changes, according to the instrument used, whose pattern varies by severity group. Nonetheless, regardless of severity, SF-6DPG always estimates a higher or equal DAD burden than the other instruments considered. These results are compatible with the presence of the floor effect in SF-6DSG, the ceiling effect in EQ-ED-5L, and a smaller presence of both biases in SF-6DPG.

Conclusions

The SF-6DPG instrument emerges as a good candidate to avoid under-estimating intangible costs within the cost-of-illness framework. However, further research is needed to assess the validity of our results in the context of other health problems.
Literature
1.
Gonçalves, R., Lourenço, A., da Silva, S.N.: A social cost perspective in the wake of the Portuguese strategy for the fight against drugs. Int. J. Drug Policy. 26(2), 199–209 (2005)
2.
Lievens, D., Vander Laenen, F., Verhaeghe, N., Putman, K., Pauwels, L., Hardyns, W., Annemans, L.: Economic consequences of legal and illegal drugs: the case of social costs in Belgium. Int. J. Drug Policy. 44, 50–57 (2017)PubMed
3.
Verhaeghe, N., Lievens, D., Annemans, L., Vander Laenen, F., Putman, K.: The health-related social costs of alcohol in Belgium. BMC Public Health. 17(1), 958 (2017)PubMedPubMedCentral
4.
WHO World Health Organization: International guidelines for estimating the costs of substance abuse. World Health Organization, Geneva (2003)
5.
Vella, V.A., Garcia-Altes, A., García, L.S., Martínez, N.I., Farran, J.C.: Systematic review of guidelines in estimating social costs on drugs. Gac. Sanit. 32(5), 481–487 (2018)
6.
Barrio, P., Reynolds, J., García-Altés, A., Gual, A., Anderson, P.: Social costs of illegal drugs, alcohol and tobacco in the European Union: a systematic review. Drug Alcohol Rev. 36(5), 578–588 (2017)PubMed
7.
Verhaeghe, N., Lievens, D., Annemans, L., Vander Laenen, F., Putman, K.: Methodological considerations in social cost studies of addictive substances: a systematic literature review. Front. Public Health. 4, 295 (2017)PubMedPubMedCentral
8.
Gao, L., Xia, L., Pan, S.Q., Xiong, T., Li, S.C.: Burden of epilepsy: a prevalence-based cost of illness study of direct, indirect and intangible costs for epilepsy. Epilepsy Res. 110, 146–156 (2015)PubMed
9.
Muennig, P., Lubetkin, E., Jia, H., Franks, P.: Gender and the disease burden attributable to obesity. Am. J. Public Health. 96(9), 1662–1668 (2006)PubMedPubMedCentral
10.
Jarl, J., Johansson, P., Eriksson, A., Eriksson, M., Gerdtham, U.G., Hemstrom, O., Selin, K.H., Lenke, L., Ramstedt, M., Room, R.: The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002. Eur. J. Health Econ. 9(4), 351–360 (2008)PubMed
11.
Konnopka, A., Konig, H.H.: The health and economic consequences of moderate alcohol consumption in germany 2002. Value Health. 12(2), 253–261 (2009)PubMed
12.
López-Bastida, J., Linertová, R., Oliva-Moreno, J., Posada de la Paz, M., Serrano-Aguilar, P.: Social economic costs and health-related quality of life in patients with systemic sclerosis in Spain. Arthritis Care Res. 66(3), 473–480 (2014)
13.
EuroQol Group: EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16(3), 199–208 (1990)
14.
Brazier, J., Roberts, J., Deverill, M.: The estimation of a preference-based measure of health from the SF-36. J. Health Econ. 21(2), 271–292 (2002)PubMed
15.
Brazier, J.E., Roberts, J.: The estimation of a preference-based measure of health from the SF-12. Med. Care. 42(9), 851–859 (2004)PubMed
16.
Ware, J.E., Snow, K.K., Kolinski, M., Gandeck, B.: SF-36 health survey manual and interpretation guide. The Health Institute, New England Medical Center, Boston (1993)
17.
Torrance, G.W.: Social preferences for health states: an empirical evaluation of three measurement techniques. Socio-Econ. Plan. Sci. 10(3), 129–136 (1976)
18.
Farquhar, P.H.: State of the art—utility assessment methods. Manag. Sci. 30(11), 1283–1300 (1984)
19.
Brazier, J., Roberts, J., Tsuchiya, A., Busschbach, J.: A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ. 13(9), 873–884 (2004)PubMed
20.
Bharmal, M., Thomas, J.: Comparing the EQ-5D and the SF-6D descriptive systems to assess their ceiling effects in the US general population. Value Health. 9, 262–271 (2006)PubMed
21.
Tsuchiya, A., Brazier, J., Roberts, J.: Comparison of valuation methods used to generate the EQ-5D and the SF-6D value sets. J Health Econ. 25, 334–346 (2006)PubMed
22.
Whitehurst, D.G., Bryan, S., Lewis, M.: Systematic review and empirical comparison of contemporaneous EQ-5D and SF-6D group mean scores. Med. Decis. Mak. 31(6), E34–E44 (2011)
23.
Longworth, L., Bryan, S.: An empirical comparison of EQ-5D and SF-6D in liver transplant patients. Health Econ. 12(12), 1061–1067 (2003)PubMed
24.
Bleichrodt, H.: A new explanation for the difference between time trade-off utilities and standard gamble utilities. Health Econ. 11, 447–456 (2002)PubMed
25.
Herdman, M., Gudex, C., Lloyd, A., Janssen, M.F., Kind, P., Parkin, D., Badia, X.: Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quali Life Res. 20(10), 1727–1736 (2011)
26.
Devlin, N.J., Shah, K.K., Feng, Y., Mulhern, B., van Hout, B.: Valuing health-related quality of life: An EQ-5 D-5 L value set for England. Health Econ. 27(1), 7–22 (2018)PubMed
27.
Ramos-Goñi, J.M., Craig, B.M., Oppe, M., Ramallo-Farina, Y., Pinto-Prades, J.L., Luo, N., Rivero-Arias, O.: Handling data quality issues to estimate the spanish EQ-5D-5L value set using a hybrid interval regression approach. Value Health. 21(5), 596–604 (2018)PubMed
28.
Abellán, J.M., Sanchez Martinez, F.I., Martinez Perez, J.E., Mendez, I.: Lowering the 'floor' of the SF-6D scoring algorithm using a lottery equivalent method. Health Econ. 21(11), 1271–1285 (2012)
29.
McCord, M., De Neufville, R.: “Lottery equivalents”: reduction of the certainty effect problem in utility assessment. Manag. Sci. 32(1), 56–60 (1986)
30.
Rodríguez-Míguez, E., Pinto-Prades, J.L., Mosquera-Nogueira, J.: Eliciting health state utilities using paired-gamble methods: the role of the starting point. Value Health. 22(4), 446–452 (2019)PubMed
31.
Petrie, D., Doran, C., Shakeshaft, A., Sanson-Fisher, R.: The relationship between alcohol consumption and self-reported health status using the EQ5D: evidence from rural australia. Soc. Sci. Med. 67(11), 1717–1726 (2008)PubMed
32.
Ciketic, S., McKetin, R., Doran, C.M., Najman, J.M., Veerman, J.L., Hayatbakhsh, R.M.: Health-related quality of life (HRQL) among methamphetamine users in treatment. Ment. Health Subst. Use. 6(3), 250–261 (2013)
33.
Essex, H.N., White, I.R., Khadjesari, Z., Linke, S., McCambridge, J., Murray, E., Parrott, S., Godfrey, C.: Quality of life among hazardous and harmful drinkers: EQ-5D over a 1-year follow-up period. Qual Life Res. 23(2), 733–743 (2014)PubMed
34.
Aden, B., Dunning, A., Nosyk, B., Wittenberg, E., Bray, J.W., Schackman, B.R.: Impact of illicit drug use on health-related quality of life in opioid dependent patients undergoing HIV treatment. J. Acquir. Immune Defic. Syndr. 70(3), 304 (2015)PubMedPubMedCentral
35.
Nogueira, J.M., Rodriguez-Miguez, E.: Using the SF-6D to measure the impact of alcohol dependence on health-related quality of life. Eur J Health Econ. 16(4), 347–356 (2015)PubMed
36.
Tran, B.X., Nguyen, L.T.: Impact of methadone maintenance on health utility, health care utilization and expenditure in drug users with HIV/AIDS. Int. J. Drug Policy. 24(6), e105–e110 (2013)PubMed
37.
Beattie, A., Marques, E.M., Barber, M., Greenwood, R., Ingram, J., Ayres, R., Neale, A., Coleman, B., Hickman, M.: Script in a day intervention for individuals who are injecting opioids: a feasibility randomized control trial. J. Public Health. 38(4), 712–721 (2015)
38.
Shiroiwa, T., Fukuda, T., Ikeda, S., Igarashi, A., Noto, S., Saito, S., Shimozuma, K.: Japanese population norms for preference-based measures: EQ-5D-3L, EQ-5D-5L, and SF-6D. Qual. Life Res. 25(3), 707–719 (2016)PubMed
39.
StataCorp: Stata statistical software: release 14. StataCorp LP, College Station (2015)
40.
Monwell, B., Bülow, P., Gerdner, A.: Type of opioid dependence among patients seeking opioid substitution treatment: are there differences in background and severity of problems? Subst. Abuse Treat. Prev. Policy. 11(1), 1–8 (2016)
41.
42.
Richardson, J., Khan, M.A., Iezzi, A., Maxwell, A.: Comparing and explaining differences in the magnitude, content, and sensitivity of utilities predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D multiattribute utility instruments. Med. Decis. Mak. 35(3), 276–291 (2015)
43.
Janssen, M.F., Pickard, A.S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., Swinburn, P., Busschbach, J.: Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res. 22, 1717–1727 (2013)PubMed
44.
Kim, T.H., Jo, M.W., Lee, S.I., Kim, S.H., Chung, S.M.: Psychometric properties of the EQ-5D-5L in the general population of south korea. Qual Life Res. 22, 2245–2253 (2013)PubMed
45.
Sayah, F.A., Qiu, W., Xie, F., Johnson, J.A.: Comparative performance of the EQ-5D-5L and SF-6D index scores in adults with type 2 diabetes. Qual Life Res. 26, 2057–2066 (2017)PubMed
46.
Barton, G.R., Bankart, J., Davis, A.C., Summerfield, Q.A.: Comparing utility scores before and after hearing-aid provision. Appl. Health Econ. Health Policy. 3(2), 103–105 (2004)PubMed
47.
Petrou, S., Hockley, C.: An investigation into the empirical validity of the EQ-5D and SF-6D based on hypothetical preferences in a general population. Health Econ. 14(11), 1169–1189 (2005)PubMed
48.
Luo, N., Wang, P., Fu, A.Z., Johnson, J.A., Coons, S.J.: Preference-based SF-6D scores derived from the SF-36 and SF-12 have different discriminative power in a population health survey. Med. Care 50, 627–632 (2012)PubMed
49.
Abdin, E., Chong, S.A., Seow, E., Peh, C.X., Tan, J.H., Liu, J., Vaingankar, J.A.: A comparison of the reliability and validity of SF-6D, EQ-5D and HUI3 utility measures in patients with schizophrenia and patients with depression in Singapore. Psychiatry Res. 274, 400–408 (2019)PubMed
50.
Obradovic, M., Lal, A., Liedgens, H.: Validity and responsiveness of EuroQol-5 dimension (EQ-5D) versus Short Form-6 dimension (SF-6D) questionnaire in chronic pain. Health Qual. Life Outcomes. 11(1), 110 (2013)PubMedPubMedCentral
51.
Yang, F., Lau, T., Lee, E., Vathsala, A., Chia, K.S., Luo, N.: Comparison of the preference-based EQ-5D-5L and SF-6D in patients with end-stage renal disease (ESRD). Eur. J. Health Econ. 16(9), 1019–1026 (2015)PubMed
52.
Kahneman, D., Tversky, A.: Prospect theory an analysis of decision under risk. Econometrica 47, 263–291 (1979)
53.
Wakker, P., Deneffe, D.: Eliciting von Neumann-Morgenstern utilities when probabilities are distorted or unknown. Manag. Sci. 42(8), 1131–1150 (1996)
54.
Pinto-Prades, J.L., Abellán-Perpiñán, J.M.: Measuring the health of populations: the veil of ignorance approach. Health Econ. 14(1), 69–82 (2005)PubMed
55.
Dunn, K.M., Jordan, K., Croft, P.R.: Does questionnaire structure influence response in postal surveys? J. Clin. Epidemiol. 56(1), 10–16 (2003)PubMed
56.
Cheung, Y.B., Wong, L.C., Tay, M.H., Toh, C.K., Koo, W.H., Epstein, R., Goh, C.: Order effects in the assessment of quality of life in cancer patients. Qual. Life Res. 13(7), 1217–1223 (2004)PubMed
Metadata
Title
Measuring intangible cost-of-morbidity due to substance dependence: implications of using alternative preference-based instruments
Authors
Bruno Casal
Eva Rodríguez-Míguez
Berta Rivera
Publication date
01-09-2020
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 7/2020
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-020-01196-7

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