Estimating Long-Term Health Utility Scores and Expenditures for Cardiovascular Disease From the Medical Expenditure Panel Survey

Jacob R. Morey, Shangqing Jiang, Sharon Klein, Wendy Max, Umesh Masharani, Kirsten E. Fleischmann, M. G.Myriam Hunink, Bart S. Ferket*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Long-term health utility scores and costs used in cost-effectiveness analyses of cardiovascular disease prevention and management can be inconsistent, outdated, or invalid for the diverse population of the United States. Our aim was to develop a user friendly, standardized, publicly available code and catalog to derive more valid long-term values for health utility and expenditures following cardiovascular disease events. Methods: Individual-level Short Form-12 version 2 health-related quality of life and expenditure data were obtained from the pooled 2011 to 2016 Medical Expenditure Panel Surveys. We developed code using the R programming language to estimate preference-weighted Short Form-6D utility scores from the Short Form-12 for quality-adjusted life year calculations and predict annual health care expenditures. Result predictors included cardiovascular disease diagnosis (myocardial infarction, ischemic stroke, heart failure, cardiac dysrhythmias, angina pectoris, and peripheral artery disease), sociodemographic factors, and comorbidity variables. Results: The cardiovascular disease diagnoses with the lowest utility scores were heart failure (0.635 [95% CI, 0.615-0.655]), angina pectoris (0.649 [95% CI, 0.630-0.667]), and ischemic stroke (0.649 [95% CI, 0.635-0.663]). The highest annual expenditures were for heart failure ($20 764 [95% CI, $17 500-$24 027]), angina pectoris ($18 428 [95% CI, $16 102-$20 754]), and ischemic stroke ($16 925 [95% CI, $15 672-$20 616]). Conclusions: The developed code and catalog may improve the quality and comparability of cost-effectiveness analyses by providing standardized methods for extracting long-term health utility scores and expenditures from Medical Expenditure Panel Survey data, which are more current and representative of the US population than previous sources.

Original languageEnglish
Article numberE006769
JournalCirculation: Cardiovascular Quality and Outcomes
Issue number4
Publication statusPublished - Apr 2021

Bibliographical note

Funding Information:
This work was supported by American Diabetes Association Grant no. 1-18-ICTS-041 (Drs Max, Masharani, Fleischmann, Hunink, and Ferket) and the Glo-rney-Raisbeck Medical Student Grant in Cardiovascular Disease Research from The New York Academy of Medicine (J.R. Morey).

Publisher Copyright: © 2021 Lippincott Williams and Wilkins. All rights reserved.


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