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Related Experiment Video

Updated: Jul 15, 2026

Measurement of Lifespan in Drosophila melanogaster

Measurement of Lifespan in Drosophila melanogaster

Published on: January 7, 2013

Not all "quality-adjusted life years" are equal.

C A Marra¹, S A Marion, D P Guh

¹Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Journal of Clinical Epidemiology

|May 12, 2007

Summary

Different methods for calculating quality-adjusted life years (QALYs) significantly impact economic evaluations. Choosing a utility elicitation method affects whether infliximab plus methotrexate is deemed cost-effective for rheumatoid arthritis.

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Area of Science:

Health Economics
Pharmacoeconomics
Rheumatology

Background:

Utility elicitation methods for quality-adjusted life years (QALYs) produce varied results.
The impact of these discrepancies on economic evaluations remains unclear.

Purpose of the Study:

To assess how different utility elicitation methods influence the cost-effectiveness of infliximab plus methotrexate (MTX) for rheumatoid arthritis.

Main Methods:

A 10-year mathematical model simulated 100,000 rheumatoid arthritis patients.
Quality-adjusted life years (QALYs) were derived using Health Utilities Index 2 and 3 (HUI2, HUI3), Short Form 6-D (SF-6D), and Euroqol 5-D (EQ-5D).
Incremental cost-utility ratios were compared using cost-effectiveness acceptability curves.

Main Results:

The mean difference in QALYs varied from 1.95 (HUI3) to 0.89 (SF-6D).
At a willingness to pay of $50,000 per QALY, 91% of simulations favored infliximab plus MTX using HUI3.
However, using EQ-5D, HUI2, and SF-6D, only 63%, 45%, and 12% of simulations favored cost-utility, respectively.

Conclusions:

The choice of utility elicitation method significantly alters incremental cost-utility ratios.
This variability impacts the perceived cost-effectiveness of treatments like infliximab plus MTX.