title: Health state utilities associated with attributes of treatments for hepatitis C.
abstract: BACKGROUND
  Cost-utility analyses are frequently conducted to compare treatments for hepatitis C, which are often associated with complex regimens and serious adverse events. Thus, the purpose of this study was to estimate the utility associated with treatment administration and adverse events of hepatitis C treatments.
  
  
  METHODS
  Health states were drafted based on literature review and clinician interviews. General population participants in the UK valued the health states in time trade-off (TTO) interviews with 10- and 1-year time horizons. The 14 health states described hepatitis C with variations in treatment regimen and adverse events.
  
  
  RESULTS
  A total of 182 participants completed interviews (50% female; mean age = 39.3 years). Utilities for health states describing treatment regimens without injections ranged from 0.80 (1 tablet) to 0.79 (7 tablets). Utilities for health states describing oral plus injectable regimens were 0.77 (7 tablets), 0.75 (12 tablets), and 0.71 (18 tablets). Addition of a weekly injection had a disutility of -0.02. A requirement to take medication with fatty food had a disutility of -0.04. Adverse events were associated with substantial disutilities: mild anemia, -0.12; severe anemia, -0.32; flu-like symptoms, -0.21; mild rash, -0.13; severe rash, -0.48; depression, -0.47. One-year TTO scores were similar to these 10-year values.
  
  
  CONCLUSIONS
  Adverse events and greater treatment regimen complexity were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of hepatitis C. The resulting utilities may be used in models estimating and comparing the value of treatments for hepatitis C.
authors.affiliation: Outcomes Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA. louis.matza@evidera.com.
authors.forename: Louis S
authors.initials: LS
authors.lastname: Matza
authors.affiliation: Global Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA.
authors.forename: Sandhya J
authors.initials: SJ
authors.lastname: Sapra
authors.affiliation: NHS Tayside and Medical Research Institute, University of Dundee, Dundee, UK.
authors.forename: John F
authors.initials: JF
authors.lastname: Dillon
authors.affiliation: Global Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA.
authors.forename: Anupama
authors.initials: A
authors.lastname: Kalsekar
authors.affiliation: Outcomes Research, Evidera, London, UK.
authors.forename: Evan W
authors.initials: EW
authors.lastname: Davies
authors.affiliation: Outcomes Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Devine
authors.affiliation: Outcomes Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA.
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Jordan
authors.affiliation: Outcomes Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Landrian
authors.affiliation: Department of Economics, McMaster University, Hamilton, ON, Canada.
authors.forename: David H
authors.initials: DH
authors.lastname: Feeny
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D004333:Drug Administration Routes; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006304:Health Status; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D011788:Quality of Life; D012959:Socioeconomic Factors; D006113:United Kingdom
keywords: Cost-utility; Hepatitis C; Time horizon; Time trade-off; Treatment process utility; Utility