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Joint Utility Estimators in Substance Use Disorders.

Eve Wittenberg1, Jeremy W Bray2, Achamyeleh Gebremariam3

  • 1Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
|March 16, 2017
PubMed
Summary
This summary is machine-generated.

The minimum estimator accurately reflects joint health utilities for substance use disorders (SUDs) and their co-occurring conditions. Additive and multiplicative estimators were found inadequate for economic evaluations in this context.

Keywords:
cost-utility analysispreferencessubstance useutility

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Area of Science:

  • Health Economics
  • Psychiatry
  • Biostatistics

Background:

  • Co-occurring conditions are frequent in substance use disorders (SUDs).
  • Existing methods for estimating joint health utilities have not been validated for SUDs.
  • Accurate utility estimation is crucial for economic evaluations of SUD interventions.

Purpose of the Study:

  • To compare different joint health state utility estimators within the context of SUDs.
  • To identify the most reliable methods for informing economic evaluations related to SUDs.

Main Methods:

  • Conducted internet-based surveys of US adults to gather standard gamble utilities.
  • Collected utilities for six individual SUD-related conditions and four common combinations.
  • Applied six joint utility estimators and compared their performance against observed utilities using bias and RMSE.

Main Results:

  • The minimum estimator demonstrated statistical unbiasedness across all measured combination states.
  • The maximum estimator was unbiased for two states; linear index and adjusted decrement for one state each.
  • The minimum and linear index estimators showed the smallest Root Mean Square Error (RMSE) for one state each, while the maximum estimator had the smallest RMSE for two states. Additive and multiplicative estimators exhibited the largest RMSE across all states.

Conclusions:

  • The minimum estimator is a useful and reliable method for joint utility estimation in SUD contexts.
  • Additive and multiplicative utility estimators are inadequate for economic evaluations involving SUDs and co-occurring conditions.
  • Further research is recommended to explore the applicability of these findings to a broader range of SUD states.