PURPOSE: Attendees will learn how to identify and critically appraise utilities in a systematic and transparent way to meet the needs of the model, as well as reimbursement agencies, if/when to synthesize, considerations and assumptions when using HSU estimates in cost-effectiveness models, and reporting standards. The audience work through several systematic review examples to illustrate the “hows” and “whys” behind the task force’s proposed checklist.
DESCRIPTION: HSU estimates can drive results of cost effectiveness analysis. Currently, little attention is paid to evidence sources and methods used to apply these estimates in models. The absence of rigorous standards can lead to ”cherry picking” data that produce the most favorable cost per QALY. We will describe the methods for identification and appraisal of utilities to answer the question: Are comprehensive or structured searches best? We will then discuss the considerations in HSU evidence synthesis answering questions on if/when to synthesize, the appropriateness of combining estimates obtained from different measures, minimum data points needed, the use of mapped values, and alternative methods of synthesis. We then will work through the factors and assumptions to consider when using HSU estimates in cost-effectiveness models, including comorbidities, treatment related adverse events, concurrent clinical events, and the importance of capturing uncertainty. In our final example, we will examine reporting of the selection and synthesis of HSU estimates, including the search strategy, relevance of the criteria applied, and strengths and limitations of the evidence.
Presented by the ISPOR HSU Estimates in Cost Effectiveness Models Good Practices Task Force