Utility estimation of hypothetical chronic obstructive pulmonary disease health states by the general population and health professionals

Purpose: This study attempted to estimate the utility weights for hypothetical chronic obstructive pulmonary disease (COPD) health states, including the effect of exacerbation, and based on utilities elicited from a representative sample using the time trade-off (TTO). Methods: A total of 200 study subjects were recruited using a quota sampling method in Seoul, Korea. Ten COPD health profiles were described reflecting the severity of COPD and the extent of exacerbation. Respondents evaluated each health state using a visual analogue scale and TTO during a personal interview. TTO values were estimated using a linear mixed model, and the model performance was evaluated in terms of its predictive ability and goodness of fit. Results: The estimated TTO values were 0.824 in moderate, 0.646 in severe, and 0.305 in very severe COPD health states. The estimated utility decrements in TTO varied from 0.082 for a non-serious exacerbation to 0.228 for one non-serious plus one serious exacerbation per year. The mean absolute error of the TTO model was 0.008, and the generalized R-2 was 0.86. Conclusion: The social preference of various COPD health states and the utility decrement due to exacerbation can be useful for the economic evaluation of COPD intervention in Korea.