Article

Valuing the Health States Associated with Chlamydia trachomatis Infections and Their Sequelae: A Systematic Review of Economic Evaluations and Primary Studies

Value in Health (Impact Factor: 3.28). 01/2014; 17(1):116-30. DOI: 10.1016/j.jval.2013.10.005
Source: PubMed

ABSTRACT

Economic evaluations of interventions to prevent and control sexually transmitted infections such as Chlamydia trachomatis are increasingly required to present their outcomes in terms of quality-adjusted life-years using preference-based measurements of relevant health states. The objectives of this study were to critically evaluate how published cost-effectiveness studies have conceptualized and valued health states associated with chlamydia and to examine the primary evidence available to inform health state utility values (HSUVs).
A systematic review was conducted, with searches of six electronic databases up to December 2012. Data on study characteristics, methods, and main results were extracted by using a standard template.
Nineteen economic evaluations of relevant interventions were included. Individual studies considered different health states and assigned different values and durations. Eleven studies cited the same source for HSUVs. Only five primary studies valued relevant health states. The methods and viewpoints adopted varied, and different values for health states were generated.
Limitations in the information available about HSUVs associated with chlamydia and its complications have implications for the robustness of economic evaluations in this area. None of the primary studies could be used without reservation to inform cost-effectiveness analyses in the United Kingdom. Future debate should consider appropriate methods for valuing health states for infectious diseases, because recommended approaches may not be suitable. Unless we adequately tackle the challenges associated with measuring and valuing health-related quality of life for patients with chlamydia and other infectious diseases, evaluating the cost-effectiveness of interventions in this area will remain problematic.

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Available from: Peter Auguste, Jul 30, 2014
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    • "If these costs are higher, for example due to multiple IVF rounds or PID episodes, then our analysis will underestimate the potential cost savings from preventing PID and TFI. A recent systematic review[22]found that there are significant problems in using current available values for health state utility (from which QALYs are derived) for PID and TFI, and in fact in assigning values at all to TFI in particular. Since cost-effectiveness is sensitive to, and indeed dependent on, the assumed health state disutility associated with the outcomes, caution is advised in interpreting the calculated values for the cost per QALY gained for current and alternative chlamydia testing strategies. "
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