Health State Utility Values for Type 2 Diabetes and Related Complications in East and Southeast Asia: A Systematic Review and Meta-Analysis

• Published in: Value in health 2021-07, Vol.24 (7), p.1059-1067
• Main Authors: Mok, Chiu Hang, Kwok, Harley H.Y., Ng, Carmen S., Leung, Gabriel M., Quan, Jianchao
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Amputation; Asia; Asia, Southeastern; Body mass index; Choice Behavior; Complications; Cost analysis; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Disease management; Health care; Health economics; Health Status; Humans; Meta-analysis; Middle Aged; Quality of Life; Reviews; Systematic review; Type 2 diabetes mellitus; utility; Valuation; Young Adult
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2020.12.019

East and Southeast Asia has the greatest burden of diabetes in the world. We sought to derive a reference set of utility values for type 2 diabetes without complication and disutility (utility decrement) values for important diabetes-related complications to better inform economic evaluation. A systematic review to identify utility values for diabetes and related complications reported in East and Southeast Asia. We searched MEDLINE (OVID) from inception to May 26, 2020 for utility values elicited using direct and indirect methods. Identified studies were assessed for quality based on the National Institute of Health and Care Excellence guidelines. Utility and disutility estimates were pooled by meta-analyses with subgroup analyses to evaluate differences by nationality and valuation instrument. (PROSPERO: CRD42020191075). We identified 17 studies for the systematic review from a total of 13 035 studies in the initial search, of which 13 studies met the quality criteria for inclusion in the meta-analyses. The pooled utility value for diabetes without complication was 0.88 (95% CI 0.83-0.93), with the pooled utility decrement for associated complications ranged from 0.00 (for excess BMI) to 0.18 (for amputation). The utility values were consistently more conservative than previous estimates derived in Western populations. Utility decrements were comparable for SF-6D and EQ-5D valuation instruments and for Chinese and other Asian groups. A reference set of pooled disutility and utility values for type 2 diabetes and its complications in East and Southeast Asian populations yielded more conservative estimates than Western populations. •Despite the high prevalence and burden of diabetes in East and Southeast Asia, there lacks a set of utility values for diabetes-related complications to assess quality of life and to conduct economic evaluation in these populations. Utility reference values in other populations have previously been selected based on qualitative analysis alone.•We developed a reference set of pooled disutility and utility values for type 2 diabetes and its related complications for East and Southeast Asia from a systematic review and meta-analysis. We found these populations consistently yielded more conservative values for disutility than previous estimates in Western populations. We also assessed variations due to nationality and valuation instrument.•We propose a reference set of pooled utility values to aid researchers and public health poli