Valuation Of Health States for Scleroderma and Psoriatic Arthritis by the General Public: Community Weights for Future Decision and Cost-effectiveness Analyses

Objective: The US Public Health Service Panel on Cost-Effectiveness in Health and Medicine recommends assessing utilities (health values or quality-of-life weights) from the general public rather than from patients with the condition being evaluated. Our objective was to assess community utilities for health states common to people with scleroderma (SSc) and psoriatic arthritis (PsA).
Methods: Subjects were recruited through flyers and advertisements in local newspapers and completed 2 health status measures, the SF-12 version 2 and the Health Assessment Questionnaire-Disability Index (HAQ-DI); rated their own health on a 0-100 rating scale (RS); and completed computer-assisted time trade-off (TTO, possible range: 0.0-1.0) and standard gamble (SG, possible range: 0.0-1.0) utility assessments for their own health. Subjects next were given a brief description of several SSc and PsA health states derived from the Quality of Well-being scale and were asked to imagine living in each of those states for the rest of their lives. Each subject assessed 3 of the following SSc health states: mild SSc, moderate SSc, severe SSc, moderate SSc with lung disease, and severe SSc with lung disease; and either mild PsA, moderate PsA, or severe PsA.
Results: A total of 218 adults completed the study; 135 (62%) were female, 143 (66%) were Caucasian, and 62 (28%) were African-Americans. The median scores for the PCS-12 (52.0), MCS-12 (49.0), and HAQ-DI (0.12) were close to population norms. Subjects’ TTO and SG utilities for their own health were generally high, and utilities for SSc and PsA were generally inversely related to health state severity (Table 1).
Conclusion: We provide community weights for future decision and cost-effectiveness analyses in SSc and PsA.

	Number	Median Score	25th-75th Percentile
Self RS	218	85.0	75-90
Self TTO	218	0.998	0.93-1.00
Self SG	218	0.992	0.88-1.00
Mild SSc
Mild RS	94	70.0	60-80
Mild TTO	94	0.94	0.67-0.99
Mild SG	94	0.90	0.75-0.99
Moderate SSc
Moderate RS	172	58.5	45-70
Moderate TTO	172	0.75	0.50- 0.93
Moderate SG	172	0.82	0.51-0.97
Moderate SSc with lung
Moderate_lung RS	177	50.0	33-60
Moderate_lung TTO	177	0.63	0.38-0.86
Moderate_lung SG	177	0.75	0.50-0.94
Severe SSc
Severe RS	120	30.0	20-40
Severe TTO	120	0.30	0.11-0.56
Severe SG	120	0.50	0.23-0.75
Severe SSc with lung
Severe_lung RS	90	20.0	13-35
Severe_lung TTO	90	0.28	0.12-0.58
Severe_lung SG	90	0.50	0.24-0.75
Mild PSA
Mild RS	70	70.0	50-80
Mild TTO	70	0.88	0.63-0.99
Mild SG	70	0.91	0.75-0.98
Moderate PSA
Moderate RS	78	50.0	36-60
Moderate TTO	78	0.69	0.25-0.81
Moderate SG	78	0.75	0.50-0.92
Severe PSA
Severe RS	66	15.0	0.03-0.50
Severe TTO	66	0.15	0.03-0.50
Severe SG	66	0.50	0.09-0.75

  D. Khanna, NIH (grant HD-051953), 2; R. Kaplan, None; M. Eckman, None; S. Ginsburg, None; R.D. Hays, None; J. Tsevat, None.