What do HTA agencies need for generating health-related quality of life evidence? Findings from a global survey

OBJECTIVES: The overall aim is to understand the practices, views, and needs of health technology assessment (HTA) practitioners worldwide regarding the use of health-related quality of life (HRQoL) data for generating cost-effectiveness evidence. METHODS: We invited HTA practitioners in sixty countries to complete an online survey on their perspectives on the measurement and valuation of health. We performed descriptive analyses of the overall sample, examined response differences across six regions, and pooled responses to open-ended questions for content analysis. RESULTS: A total of 238 individuals from 45 countries completed the survey, with a mean response number per country of 5.28 (SD: 4.45). Most responses came from public sector employees (seventy-two percent), and ninety percent were involved in cost-effectiveness-related work. The top three most frequently used utility instruments were EQ-5D, SF-6D, and EQ-5D-Y, and the elicitation methods were time trade-off, visual analogue scale, and standard gamble. Health-state preferences of the general public from another country were more frequently used than the preferences of the local public. Common data quality issues were poor sample representativeness and a small sample size of utility data. In Asia and Western Europe, the top-voted research priority was developing utility instruments that capture both healthcare and social care impact. In four regions, developing utility instruments for children was the second-highest research priority. CONCLUSIONS: The survey addressed important knowledge gaps regarding current practices in measuring and valuing HRQoL in HTA and provided insights into HTA practitioners' views on instruments, methods, and data-related challenges and needs for generating HRQoL evidence.