title: Review of utility values for economic modeling in type 2 diabetes.
abstract: OBJECTIVE
  Economic analysis in type 2 diabetes mellitus (T2DM) requires an assessment of the effect of a wide range of complications. The objective of this article was to identify a set of utility values consistent with the National Institute for Health and Care Excellence (NICE) reference case and to critically discuss and illustrate challenges in creating such a utility set.
  
  
  METHODS
  A systematic literature review was conducted to identify studies reporting utility values for relevant complications. The methodology of each study was assessed for consistency with the NICE reference case. A suggested set of utility values applicable to modeling was derived, giving preference to studies reporting multiple complications and correcting for comorbidity.
  
  
  RESULTS
  The review considered 21 relevant diabetes complications. A total of 16,574 articles were identified; after screening, 61 articles were assessed for methodological quality. Nineteen articles met NICE criteria, reporting utility values for 20 of 21 relevant complications. For renal transplant, because no articles meeting NICE criteria were identified, two articles using other methodologies were included. Index value estimates for T2DM without complication ranged from 0.711 to 0.940. Utility decrement associated with complications ranged from 0.014 (minor hypoglycemia) to 0.28 (amputation). Limitations associated with the selection of a utility value for use in economic modeling included variability in patient recruitment, heterogeneity in statistical analysis, large variability around some point estimates, and lack of recent data.
  
  
  CONCLUSIONS
  A reference set of utility values for T2DM and its complications in line with NICE requirements was identified. This research illustrates the challenges associated with systematically selecting utility data for economic evaluations.
authors: IMS Health, Basel, Switzerland. Electronic address: abeaudet@ch.imshealth.com.
authors: Amélie
authors: A
authors: Beaudet
authors: IMS Health, Basel, Switzerland.
authors: John
authors: J
authors: Clegg
authors: IMS Health, Basel, Switzerland.
authors: Per-Olof
authors: PO
authors: Thuresson
authors: IMS Health, London, UK.
authors: Adam
authors: A
authors: Lloyd
authors: Centre for Health Economics, Swansea University, Swansea, UK.
authors: Phil
authors: P
authors: McEwan
mesh_terms: D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000191:economics*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics*; D006304:Health Status; D006801:Humans; D018803:Models, Economic; D011788:Quality of Life
keywords: EQ-5D; diabetes; quality of life; systematic review; utility