Quantifying the impact of taking medicines for long-term conditions
Research type
Research Study
Full title
Quantifying the impact of taking medicines for long-term conditions: eliciting direct treatment disutility
IRAS ID
220492
Contact name
Katherine Payne
Contact email
Sponsor organisation
The University of Manchester
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Studies that generate evidence of relative cost-effectiveness of new medicines are a vital input when producing clinical guidelines or conduct technology appraisal by bodies such as the National Institute for Health and Care Excellence (NICE). Such analyses should capture the impact of all the relevant costs, benefits and harms of the intervention under evaluation. Some aspect of the harms from a medicine is usually already incorporated to at least some extent by including a negative impact on health status (disutility) associated with adverse drug reactions (ADRs). There is growing evidence that suggests that taking a specific treatment, particularly one requiring long-term use for a chronic condition, can cause inconvenience or “disutility” to a patient which is exclusive to the unwanted harms, adverse outcomes or effects from an intervention. The concept of Direct Treatment Disutility (DTD) is over and above the dis-utility (harm) captured by attaching a negative value associated with ADRs or the financial cost of out-of-pocket costs for the patient. The negative impact of taking a medicine for life, especially a preventative medicine with no obvious immediate benefits, is currently ignored in cost-effectiveness analysis. In a previous study, it was identified that even very low plausible levels of DTD could significantly reduce or even reverse expected relative cost-effectiveness of a statin treatment. There is an emerging literature in this field but there is a need to better estimate how large DTD actually is and the variation in elicited DTD values. This study will use qualitative (think aloud) and survey-based (time trade-off and best worst scaling) methods to identify and measure the impact of DTD associated with taking medicines for prevention of selected conditions (statin to prevent heart disease; bisphosphonate to prevent bone loss). The study will include the values from patients taking these medicines and the general public.
REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
17/NW/0124
Date of REC Opinion
10 Mar 2017
REC opinion
Favourable Opinion