Objectives: Type 1 diabetes is often associated with complications that may have a pronounced impact on health-related quality of life (HRQoL). The aim was to conduct a systematic literature review to identify studies conducted exclusively in type 1 diabetes populations reporting utility values for diabetes-related complications. Methods: Literature searches of the PubMed, EMBASE and Cochrane Library databases were performed in line with PRISMA guidance; searches used Medical Subject Heading (MeSH) terms supplemented with free-text terms. For inclusion, studies were required to be conducted exclusively in adults with type 1 diabetes, published in English from 2000 onwards, and report utility values determined using either direct or indirect assessment methods. Results: Searches identified a total of 20 studies reporting utility values for complications in type 1 diabetes, of which a total of 9 studies used the EQ-5D, 2 used the 15D, 3 used the Quality of Well-Being questionnaire and 5 used direct methods including time trade-off and standard gamble. For patients with no complications reported utility values ranged from 0.90-0.98. Complications including stroke (reported disutility range -0.105 to -0.291), neuropathy (range -0.055 to -0.358) and blindness (range -0.132 to -0.208) were associated with among the largest decrements in utility values. Poor glycemic control was also found to be associated with lower utility values. Data gaps in the literature exist, e.g. EQ-5D utility values for amputation and end-stage renal disease are lacking. Conclusions: Differences between type 1 and type 2 diabetes populations mean for economic evaluation it is preferable to obtain utility values from exclusively type 1 diabetes populations. In type 1 diabetes the presence of complications has a significant detrimental impact on HRQoL, but the magnitude of the impact depends on the choice of HRQoL instrument. This will have implications on cost-effectiveness models of type 1 diabetes.
Smith-Palmer, J., Boye, K., Bae, J., Norrbacka, K., Hunt, B., & Valentine, W. (2015). Systematic Literature Review of Health State Utilities for Adults With Type 1 Diabetes. Value in Health, 18(7), A613. https://doi.org/10.1016/j.jval.2015.09.2131