Development of a disease-specific health utility score for Chronic Obstructive Pulmonary Disease from a Discrete Choice Experiment patient preference study

Objectives: Whilst patient input to Health Technology Assessment (HTA) has traditionally been of a qualitative nature, there is increasing interest to integrate quantitative evidence from patient preference studies into HTA decision-making. Preference data can be used to generate disease specific health utility data. We generated a health utility score for patients with Chronic Obstructive Pulmonary Disease (COPD) and consider its use within HTAs.
Methods: Based on qualitative research, six symptoms were identified as important to COPD patients: shortness of breath, exacerbations, chronic cough, mucus secretion, sleep disturbance and urinary incontinence. We employed a Discrete Choice Experiment (DCE) and the random parameter logistic (RPL) regression technique to estimate utility scores for all COPD health states. The relationship between patients’ COPD health utility score, self-perceived COPD severity, and EQ-5D-3L utility scores was analyzed, with data stratified according to disease severity and comorbidity subgroups.
Results: The COPD health utility score had face validity, with utility scores negatively correlated with patients’ self-perceived COPD severity. Correlation between the COPD health utility scores and EQ-5D-3L values was only moderate. Whilst patient EQ-5D-3L scores were impacted by comorbidities, the COPD health utility score was less impacted by comorbid conditions.
Conclusions: Our COPD utility measure derived from a DCE, provides a patient-centered health utility score, is more sensitive to the COPD health of the individual and less sensitive to other comorbidities. This disease-specific instrument should be considered alongside generic health-related quality of life instruments when valuing new COPD therapies in submissions to licensing and reimbursement agencies.