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Comparing Cost-Utility Estimates: Does the Choice of EQ-5D or SF-6D Matter?

Sach, Tracey H. PhD*†‡; Barton, Garry R. PhD†; Jenkinson, Claire BSc‡; Doherty, Michael MD§; Avery, Anthony J. MD‡; Muir, Kenneth R. PhD‡

doi: 10.1097/MLR.0b013e3181a39428
Original Article

Background: A number of different measures can be used within cost-utility analyses, we compared results according to both the EQ-5D and SF-6D.

Methods: A randomized trial was conducted to compare 4 options for people with knee pain. Over the 2 year trial period, the change in cost to health-service was estimated, and both the EQ-5D and SF-6D were used to estimate the change in quality-adjusted life years (QALYs). Using a complete case analysis, the cost-utility (incremental cost-effectiveness ratio [ICER]) of each option, according to both the EQ-5D and SF-6D, was calculated and assessed in relation to the cost-effectiveness threshold of £20,000 per QALY.

Results: Of the 389 participants, 247 had complete cost, EQ-5D and SF-6D data. According to the EQ-5D, option 1 had an estimated ICER of £10,815 (compared with option 4), option 2 was dominated by option 1, and option 3 was subject to extended dominance. Conversely, according to the SF-6D, option 3 had an ICER of £9999 (compared with option 4), option 2 had an ICER of £36,883 (compared with option 3), and option 1 was subject to extended dominance.

Conclusion: The EQ-5D and SF-6D estimated that different options (1 and 3, respectively) were cost-effective at the £20,000 per QALY threshold, demonstrating that the choice of measure does matter.

From the *School of Chemical Sciences and Pharmacy, University of East Anglia, Norwich, United Kingdom; †Health Economics Group, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom; ‡School of Community Health Sciences, University of Nottingham, Nottingham, United Kingdom; and §Academic Rheumatology, University of Nottingham, Nottingham, United Kingdom.

The LIKP study was supported by the UK Arthritis Research Campaign (ARC) grant (13550).

Reprints: Garry Barton, PhD, Lecturer in Health Economics, Health Economics Group, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, NR4 7TJ, United Kingdom. E-mail: g.barton@uea.ac.uk.

© 2009 Lippincott Williams & Wilkins, Inc.