Health State Utility Values of Type 2 Diabetes Mellitus and Related Complications: A Systematic Review and Meta-Regresstion

OBJECTIVES: This study aimed to synthesize and quantitatively examine Health state utility values (HSUVs) for Type 2 Diabetes Mellitus (T2DM) and its complications, providing a robust meta-regression framework for the selection of appropriate HSUV estimates.

METHODS: We conducted a systematic review to extract HSUVs for T2DM and its complications, encompassing a range of influencing factors. Relevant literature was sourced from PubMed, Embase, and the Web of Science (up to March 2024), supplemented by reviews spanning 2000-2023. Multivariate meta-regression was performed to evaluate the impact of measurement tools, tariffs, health status, and clinical as well as demographic variables on HSUVs.

RESULTS: Our search yielded 118 studies, contributing 1044 HSUVs. The HSUVs for T2DM with complications varied, from 0.65 for cerebrovascular disease to 0.77 for neuropathy. The EQ-5D-3L emerged as the most frequently employed valuation method. HSUV differences across instruments were observed; 15-D had the highest (0.89), while HUI-3 had the lowest (0.70) values. Regression analysis elucidated significant effects of instrument and tariff choice on HSUVs. Complication-related utility decrement, especially in cerebrovascular disease, was quantified. Age <70 linked to increased HSUVs, while longer illness duration, hypertension, overweight and obesity correlated with reduced HSUVs.

CONCLUSIONS: Accurate HSUVs are vital for the optimization of T2DM management strategies. This study provided a comprehensive data pool for HSUVs selection, and quantified the influence of various factors on HSUVs, informing analysts and policymakers in understanding the utility variations associated with T2DM and its complications.