Generation Of Health Utility Value Set Among The Chinese General Population Based On Method Comparison

Health technology assessment（HTA）has an established role in optimizing the allocation of limited health resources,which is one of the most critical challenges faced by many countries around the world.As the gold standard of economic evaluation in HTA,the effective and widely application of the cost-utility analysis（CUA）depends on the accuracy of health utility measurement.A series of generic health utility measures has been developed over the past few decades,while the use of these measures rest with the construction of the value sets based on the preference of country-specific general population.Eliciting the health utility using different approaches and then compare with each other is the crucial research field in the present.This study aimed to explore the difference of eliciting health utility values using the novel discrete choice experiment（DCE）and the variant DCE with an added dimension for life duration(DCE_TTO)as compared with conventional Time trade-off（TTO）;and then to generate the health utility value set by using the preferred approach for the second version of Short form six-dimension（SF-6Dv2）,which is widely used across the world.Firstly,the Simplified Chinese version of SF-6Dv2 was developed and demonstrated to be understandable and easy to complete among the Chinese general population by the translation,cross-cultural adaption and psychometric test process.Secondly,the acceptability,consistency and accuracy of TTO,DCE and DCE_TTO approaches were explored among the representative sample（N=503）of Tianjin general population.This study found that DCE and DCE_TTO were not considered to be easier to understand or answer than TTO,and systematic differences in the health state utility values estimated by three approaches were observed.Thirdly,the value set of SF-6Dv2 were generated using both TTO and DCE_TTO approaches based on a large representative sample（N=3,320）of Chinese general population stratified by age,sex,education level and proportion of urban/rural population.The results of TTO performed better than DCE_TTO,and the value set generated by TTO were preferred.Lastly,the validity and reliability of the value set generated by TTO were further verified.The results obtained from this study provide the new instrument of measuring the health utility for Chinese population,which promotes the development of CUA and HTA in China.Furthermore,this study presents the first empirical evidence that directly compared the TTO,DCE and DCE_TTO approaches,based on the valuation of the SF-6Dv2.Based on the results found in this study,several suggestions are further proposed that the central government should attach importance to encouraging the relevant basic researches on the methodology and application of the generic health utility measures,as well as to its standard and fair health utility measurement results,which can be used to support the decision-making of the rational allocation of health resources.