Using the EQ-5D-5L to investigate quality-of-life impacts of disease-modifying therapy policies for people with multiple sclerosis (MS) in New Zealand |
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Authors: | Claflin Suzi Campbell Julie A Norman Richard Mason Deborah F Kalincik Tomas Simpson-Yap Steve Butzkueven Helmut Carroll William M Palmer Andrew J Blizzard C Leigh van der Mei Ingrid Henson Glen J Taylor Bruce V |
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Institution: | 1.Menzies Institute for Medical Research, University of Tasmania, Medical Science Precinct, 17 Liverpool Street, Hobart, TAS, 7000, Australia ;2.Curtin University, Perth, Australia ;3.New Zealand Brain Research Institute, Christchurch, New Zealand ;4.CORe The University of Melbourne, Melbourne, Australia ;5.Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia ;6.Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia ;7.Department of Neuroscience, Monash University, Melbourne, Australia ;8.Perron Institute, Nedlands, Australia ;9.Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia ; |
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Abstract: | Background Health state utilities (HSU) are a health-related quality-of-life (HRQoL) input for cost-utility analyses used for resource allocation decisions, including medication reimbursement. New Zealand (NZ) guidelines recommend the EQ-5D instruments; however, the EQ-5D-5L may not sufficiently capture psychosocial health. We evaluated HRQoL among people with multiple sclerosis (MS) in NZ using the EQ-5D-5L and assessed the instrument’s discriminatory sensitivity for a NZ MS cohort. MethodsParticipants were recruited from the NZ MS Prevalence Study. Participants self-completed a 45-min online survey that included the EQ-5D-5L/EQ-VAS. Disability severity was classified using the Expanded Disability Status Scale (EDSS) to categorise participant disability as mild (EDSS: 0–3.5), moderate (EDSS: 4.0–6.0) and severe (EDSS: 6.5–9.5). Anxiety/depression were also measured using the Hospital Anxiety and Depression Score (HADS). In the absence of an EQ-5D-5L NZ tariff, HSUs were derived using an Australian tariff. We evaluated associations between HSUs and participant characteristics with linear regression models. Results254 participants entered the study. Mean age was 55.2 years, 79.5% were female. Mean (SD) EQ-5D-5L HSU was 0.58 (0.33). Mean (SD) HSUs for disability categories were: mild 0.80?±?0.17, moderate 0.57?±?0.21 and severe 0.14?±?0.32. Twelve percent reported HSU?=?1.0 (i.e., no problems in any domain). Participants who had never used a disease-modifying therapy reported a lower mean HSU. Multivariable modelling found that the HADS anxiety score was not associated with EQ-5D-5L. ConclusionsHRQoL for people with MS in NZ was lower than comparable countries, including Australia. We suggest a comparison with other generic tools that may have improved sensitivity to mental health. |
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