Comparing cost-utility estimates: does the choice of EQ-5D or SF-6D matter?
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 pound20,000 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 pound10,815 (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 pound9999 (compared with option 4), option 2 had an ICER of pound36,883 (compared with option 3), and option 1 was subject to extended dominance.


CONCLUSIONS
The EQ-5D and SF-6D estimated that different options (1 and 3, respectively) were cost-effective at the pound20,000 per QALY threshold, demonstrating that the choice of measure does matter.
Sach
Tracey H
TH
School of Chemical Sciences and Pharmacy, University of East Anglia, Norwich, NR4 7TJ United Kingdom.
Barton
Garry R
GR
Jenkinson
Claire
C
Doherty
Michael
M
Avery
Anthony J
AJ
Muir
Kenneth R
KR
D003362:Cost-Benefit Analysis; D006305:Health Status Indicators; D006801:Humans; D007719:Knee Joint; D010146:Pain / Q000191:economics*; D059408:Pain Management; D019057:Quality-Adjusted Life Years; D013997:Time Factors