Use of Health State Utility Values in Cost‑Utility Analyses of Selected Infectious Diseases in Aging Populations: A Systematic Review and Critical Appraisal
, , Khuong Cao Ba, , , , , , , Nov-2025, In: PharmacoEconomics - Open, N, p. N
Overview
Abstract:
Background Health state utility values (HSUVs) are vital in cost-utility analyses (CUAs) that inform policymaking. However,suboptimal selection and application of HSUVs have been reported in areas such as cardiovascular disease and cancer. Thisstudy reviewed the methodological quality and appropriateness of HSUV in CUA use for interventions targeting infectiousdiseases in aging populations.Methods A systematic search of the MEDLINE database was conducted to identify CUAs that evaluated interventions againstsix major infectious diseases from January 2000 to July 2025. Two reviewers independently screened the identified studiesbased on eligibility criteria. The two reviewers then assessed the included studies using a modified checklist that coveredhow HSUVs were selected, elicited, and applied. Findings are summarized by descriptive statistics across the entire period(January 2000 to July 2025) and three sub-periods (2000–2009, 2010–2019, and 2020 to July 2025).Results Among the 146 included CUA studies, only 10 (7%) relied exclusively on original sources for HSUVs, while 78%used economic data, either alone or in combination with other secondary sources or assumptions. Most studies (78–91%) didnot provide sufficient rationale or descriptions for the population or how HSUVs were elicited, and 42% failed to report allutility components. Complete comparability between the CUAs and reference data for the diagnosis, severity, and countrywas observed in only 51–60% of studies. Notably, fewer than half of CUAs reported HSUVs that were consistent with theircited sources, and 80% did not discuss the limitations associated with HSUV use. Most criteria showed limited improve-ments, and in some cases declines, between January 2000 and July 2025.Conclusion CUAs of infectious diseases in aging populations are frequently associated with suboptimal practices in how HSUVsare selected, elicited, and applied. These shortcomings highlight the need for cautious interpretation of CUA data and for greatermethodological transparency. Improving the quality of economic evaluations will require systematic approaches to how HSUVsare selected and elicited, with increased investment in primary data collection and the creation of accessible utility databases
| Article number | N |
| Journal | PharmacoEconomics - Open |
| Volume | N |
| Publication status | Published - Nov-2025 |
| ISBN | 2509-4254 |