BACKGROUND: Major depressive disorder (MDD) is associated with decreased patient well-being and symptoms that can cause substantial impairments in a patient’s ability to function and even lead to suicide. Worldwide, MDD currently causes the second-most years lived with disability and is predicted to become the leading cause of disability by 2030. Utility values, capturing patient quality of life, are required in economic evaluations for new treatments undergoing reimbursement submissions. The aim of this review was to identify health state utility values (HSUVs) and disutilities in MDD for use in future economic evaluations.
METHODS: Embase, PubMed, Econlit, and Cochrane databases, plus gray literature, were searched from January 1998 through December 21, 2018, with no language or geographical restrictions, for relevant studies that reported HSUVs for patients with MDD receiving pharmacological interventions. Disutilities associated with the side effects of pharmacological interventions were also searched. Only primary utility studies were included for data extraction.
RESULTS: A total of 443 studies were identified, and 79 studies met the inclusion criteria. This review focuses on a subgroup of 28 articles that reported primary utility data from 16 unique studies across different regions. The majority of studies reported utility values captured at baseline with health states defined by study entry criteria. There was a large amount of heterogeneity in patient characteristics between the studies, including disease severity, comorbidities, number of previous major depressive episodes (MDEs), timing of current MDE, line of therapy, and previous treatments received. Three studies reported utility estimates for health states defined by specific clinical thresholds. Only one study reported disutility estimates associated with treatment side effects.
CONCLUSIONS: Published HSUVs for patients with MDD receiving pharmacological treatment were identified that can be used as parameters within future economic evaluations. However, there is a limited evidence base, and it is important to select HSUVs that are appropriate for the intervention being evaluated and that align with clinical health state definitions used within a model. Future studies are recommended to elicit HSUVs for new treatments, add more data on treatment side effects, and add to the existing evidence where there is a paucity of data.
