Health-state utility estimates for health technology assessment: a review of the manufacturers’ submissions to the French National Authority for Health

ABSTRACT

Background: Our aim was to review the selection and methods used for deriving health state utility (HSU) estimates included in the cost-utility analyses (CUA) submitted by manufacturers to the National Authority for Health (HAS) during the first 2 years after the introduction of the economic evaluation for price setting in France.

Methods: We reviewed all manufacturers’ submissions that included a CUA and were assessed by HAS by the end of October 2015 (N = 34). We reviewed the identification, selection, and methods used to estimate HSU and compared them with those recommended by HAS.

Results: A literature review to identify HSU was reported in only 13 (38%) submissions. The instruments for describing HSU were a preference-based generic instrument in 20 (59%) submissions; vignettes in five (15%); a condition-specific instrument in three (9%); and a combination of instruments in six (18%). The valuation perspective was the general population in 26 (76%) submissions; in only nine (26%) submissions, the valuation set was derived from the French general population.

Conclusions: We identified numerous concerns in the selection, valuation and use of HSU, as well as a frequent lack of clarity in the methods used. Most submissions (79%) included HSU that did not meet HAS recommendations.

KEYWORDS:

• Economic evaluation
• health-related quality of life
• health-state utility
• quality-adjusted life-years
• France

Acknowledgments

The authors are grateful to the members of the HAS’ Department of Economic and Public Health Evaluation (SEESP) and of HAS’ Economic and Public Health Evaluation Committee (CEESP), who performed the critical assessments of the economic evaluations submitted by the manufacturers. The authors wish to thank Margaret Galbraith for proofreading the article. The findings and conclusions of this study are those of the authors and do not necessarily represent the views of HAS.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.