Defining utility values for patients with tardive dyskinesia

Abstract

Objective

To measure health state preferences and estimate utility values for tardive dyskinesia (TD) from the perspective of the US general population, accounting for factors affecting quality of life (QOL).

Methods

Participants from the general population were recruited and asked to watch and assess videos of professional actors simulating nine health states, including psychiatric disorders with/without TD and moderate-to-severe TD without any underlying disease. Time tradeoff (TTO) methods were used to elicit utility values, which ranged from −1 (worse than death) to +1 (perfect health) and represented individual preferences for avoiding specific health states associated with TD. Lower TTO utility values indicated individuals’ willingness to give up more years of life to avoid living in each health state.

Results

Based on TTO responses (n = 157), mean ± standard deviation utility for TD alone was 0.59 ± 0.38. Mean utilities for schizophrenia with negative symptoms (without TD: 0.43; with TD: 0.29) and positive symptoms (without TD: 0.44; with TD: 0.30) were generally lower than those for bipolar disorder (without TD: 0.59; with TD: 0.46) and major depressive disorder (without TD: 0.60; with TD: 0.44). According to utility decrements associated with TD (0.13–0.16), respondents were willing to give up 1.3 to 1.6 years during a 10-year lifespan to avoid living with TD.

Conclusions

Utility decrements for TD in this study were slightly larger than previously reported values, potentially due to incorporation of QOL and social consequences in TD health state descriptions. An important limitation of this analysis is that participants’ willingness to trade future years of healthy life may not indicate actual willingness to accept the life decrement. These findings can be leveraged to improve cost-effectiveness analyses used to assess the value of treatments for TD.

Keywords:

• Tardive dyskinesia
• utility values
• quality of life
• social stigma
• time tradeoff

Transparency

Declaration of funding

This study was funded by Teva Pharmaceutical Industries Ltd., Tel Aviv, Israel.

Declaration of financial/other relationships

RA, DG, and MZ are employees of Analysis Group, Inc. RR and SL are employees of Teva Pharmaceuticals. SNC has been a consultant for Teva, Neurocrine, Osmotica Pharmaceuticals, and DisperSol Technologies, and has received research grants from Neurocrine, Osmotica Pharmaceuticals, and Eagle Pharmaceuticals. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

RA, DG, and MZ contributed to the conception and design of the analysis, the analysis and interpretation of the data, and the drafting of the manuscript. RR and SL contributed to the conception and design of the analysis, the interpretation of the data, and the drafting of the manuscript. SNC contributed to the interpretation of the data and the drafting of the manuscript. All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Acknowledgements

We thank Caryn Gordon, PharmD (Cello Health Communications/MedErgy with funding from Teva Pharmaceuticals) for editorial assistance in the preparation of this manuscript.

Data availability  statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Previous presentations

These data were previously presented, in part, at the 20th World Psychiatric Association (WPA) World Congress of Psychiatry Virtual Congress, which was held from 10–13 March 2021, and at the Academy of Managed Care Pharmacy (AMCP) Virtual National Meeting, which was held from 12–16 April 2021.