A utility value rates a health state according to preferences on a scale that is used in health economic analyses to calculate quality-adjusted life years. Full health is usually represented by 1; values below 0 can express states that respondents rate as worse than death. The utility value is therefore not a simple symptom measure, but a preference weighting of a health state.<\/p>\n
Utility values combine the duration and quality of a health state into QALYs. One year in a state with a utility value of 0.5 contributes, arithmetically, half a quality-adjusted life year. In a cost-utility analysis, they make it possible to map different consequences of a treatment\u2014such as longer survival, symptom reduction, or side effects\u2014onto a shared health-related outcome measure.<\/p>\n
The scale is not limited to values between 0 and 1. For particularly burdensome states, negative values can occur. It follows that a utility value must not be equated with a percentage figure for health. Its meaning depends on the valuation method used, the reference population, and the underlying tariff.<\/p>\n
Direct methods such as time trade-off and standard gamble have respondents rate an experienced or hypothetical health state. In the indirect approach, a classification system describes the state; a scoring algorithm then assigns it a utility value. IQWiG names, among others, EQ-5D, SF-12, SF-36, and the Health Utility Index as instruments or systems for this purpose.<\/p>\n
For indirect methods, a tariff validated for Germany is important. In addition, a model should ideally use the same method for determining utility values across all health states considered. Different instruments can rate the same clinical state differently, thereby changing the incremental QALYs of a model calculation.<\/p>\n
A patient-reported outcome can capture symptoms, function, satisfaction, or health-related quality of life. It is not automatically a utility value, because it need not provide a preference-based weighting on the utility scale. The existing entry on patient-reported outcomes therefore covers a broader concept of data collection than the health-economic utility value.<\/p>\n
Quality of life is also not synonymous with the term. Health-related quality of life can be reported directly using questionnaire scores. A utility value only arises when health states are evaluated through a preference-based method or a validated tariff. A quality-of-life questionnaire may be suitable for this, but only if it allows a valid utility value to be derived.<\/p>\n
Preferences can be elicited from patients, the general population, medical staff, or other respondents. This choice is not neutral: people with their own experience of illness may rate a state differently than people without that experience. For a cost-utility analysis, it must therefore be transparent who provided the preferences and which tariff was used. A change in tariff can produce different QALY results even with identical questionnaire responses.<\/p>\n
Utility values are also frequently modeled as time-dependent. An acute adverse event can cause a short-term loss, while a permanent limitation affects many model cycles. The data must not obscure this time structure. If only average values over long intervals are reported, it may be necessary to check whether the assumed course adequately reflects the actual burden before and after an event.<\/p>\n
For interpretation, it remains important that two people with the same clinical finding can have different preferences. The tariff used condenses these differences into a single value for the analysis, but it does not replace an individual patient perspective.<\/p>\n
A utility value is therefore a necessary model input, but not a complete judgment about life with a condition. Qualitative patient experiences and individual dimensions of quality of life can be important, even if they cannot be fully expressed in a preference value.<\/p>\n
When transferring values into a model, utility values must also be clearly assigned to the relevant health states. If several states are described simultaneously, care must be taken that the same loss is not inadvertently counted twice\u2014for symptoms and for side effects\u2014in the QALY calculation.<\/p>\n
In studies, the preference-based instrument must match the target population, the assessment schedule, and the expected changes. Missing values, assessment during acute events, and differences between paper-based and digital data collection can affect the resulting utility curves. When the values are used as model inputs, data interfaces require clear specifications regarding the measurement time point, the tariff, and the rules for assigning values to health states.<\/p>\n
Full-service CROs such as Mediconomics support the selection and implementation of preference-based questionnaires, the training of investigator sites, and the quality assurance of patient-reported data. Data management can monitor assessment windows, while biostatistics structures and prepares utility value trajectories and missing observations for the health-economic analysis.<\/p>\n
Is a utility value of 0 equivalent to death?<\/strong><\/p>\n In the usual anchoring of the scale, 0 corresponds to death; individual ratings can fall below 0 for certain states.<\/p>\n Can a quality-of-life questionnaire readily provide QALYs?<\/strong><\/p>\n No. It requires a preference-based utility value derivation or a corresponding classification system with a suitable tariff.<\/p>\n Why can different utility values arise for the same state?<\/strong><\/p>\n The instrument, tariff, valuation method, and the underlying preference sample can all lead to different weightings.<\/p>\n A utility value rates a health state according to preferences on a scale that is used in health economic analyses to calculate quality-adjusted life years. Full health is usually represented by 1; values below 0 can express states that respondents rate as worse than death. The utility value is therefore not a simple symptom measure, […]<\/p>\n","protected":false},"author":10,"featured_media":0,"parent":0,"template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"glossary-cat":[28],"class_list":["post-8169","glossary","type-glossary","status-publish","hentry","glossary-cat-market-access-heor"],"acf":[],"related_terms":"","external_url":"","internal_reference_id":"","_links":{"self":[{"href":"https:\/\/mediconomics.com\/en\/wp-json\/wp\/v2\/glossary\/8169","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mediconomics.com\/en\/wp-json\/wp\/v2\/glossary"}],"about":[{"href":"https:\/\/mediconomics.com\/en\/wp-json\/wp\/v2\/types\/glossary"}],"author":[{"embeddable":true,"href":"https:\/\/mediconomics.com\/en\/wp-json\/wp\/v2\/users\/10"}],"version-history":[{"count":0,"href":"https:\/\/mediconomics.com\/en\/wp-json\/wp\/v2\/glossary\/8169\/revisions"}],"wp:attachment":[{"href":"https:\/\/mediconomics.com\/en\/wp-json\/wp\/v2\/media?parent=8169"}],"wp:term":[{"taxonomy":"glossary-cat","embeddable":true,"href":"https:\/\/mediconomics.com\/en\/wp-json\/wp\/v2\/glossary-cat?post=8169"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Regulatory References<\/h2>\n
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