Capturing Patient Value in an Economic Evaluation

Area of Science:

• Health Economics
• Rheumatology
• Health Services Research

Background:

• Generic health status measures like EQ-5D are standard in economic evaluations but may not fully capture patient-specific quality of life.
• The shift towards patient-centered and remote care necessitates exploring disease-specific measures for cost-effectiveness analyses.

Purpose of the Study:

• To evaluate the utility of disease-specific measures in cost-effectiveness analyses for rheumatoid arthritis (RA).
• To compare the cost-effectiveness of electronic versus face-to-face consultations using both generic and RA-specific outcome measures.

Main Methods:

• A cohort of 772 RA patients from Maasstad Hospital (2020-2021) was analyzed.
• Incremental Cost-Effectiveness Ratios (ICERs) were calculated using EQ-5D, Rheumatoid Arthritis Impact of Disease (RAID), and Health Assessment Questionnaire-Disability Index (HAQ-DI).
• RAID and HAQ-DI were converted to Quality-Adjusted Life-Years (QALYs) using estimated equations.

Main Results:

• E-consultations were found to be cost-effective, with ICERs indicating cost savings per QALY gained across all measures.
• Conventional ICER (EQ-5D) showed cost savings of -€161,000 per QALY.
• RA-specific measures yielded similar cost-effectiveness results: -€163,000 per HAQ-DI (QALY) and -€223,000 per RAID (QALY).

Conclusions:

• Disease-specific patient-reported outcome measures (PROMs) provide a more comprehensive assessment of patient-relevant domains in economic evaluations.
• Modeling conversion equations for PROMs is crucial for their integration into economic evaluations.
• RA-specific measures enhance the assessment and treatment of RA impact, aligning with patient-centered care goals.