Grant round winners 2009

When the National Institute for Health and Clinical Excellence (NICE) decides if a treatment should be available on the NHS, value for money is a very important factor. “Value” is measured in quality-adjusted life years, or QALYs, and this takes into account both the additional life the treatment will give a patient, and the quality of life that the patient will have during this time.

QALYS are currently measured using a generic questionnaire, i.e. one that is not specific to any one condition. This questionnaire is unlikely to pick up small improvements in quality of life that anti-epileptic drugs (AEDs) bring, and therefore AEDs might appear to be less cost-effective than they actually are.

An epilepsy-specific questionnaire for deriving QALYs could be useful for clinical trials, and could potentially improve health economic assessments that inform decisions made by NICE and other health bodies.

Professor John Brazier, from the University of Sheffield and Dr Dyfrig Hughes, from Bangor University, have been awarded £67,305, over 18 months, to carry out a project entitled Health economic evaluations in epilepsy: Developing a preference-based outcome measure, in which they will try to develop such a questionnaire using methods that have been tested in other disease areas by their research team.

In producing this tool, the group will test two theories:

  1. That an epilepsy-specific questionnaire is superior in psychometric terms to the generic one
  2. That QALY scores in the general population differ significantly from people with epilepsy

The questionnaire will be tested and validated in at least 184 people with epilepsy, and a control group (of people without epilepsy), to produce a new QALY scoring system. This system will then be used to assess the cost-effectiveness of treatments for epilepsy.

Once these calculations have been made, the researchers will be able to compare the results from the new questionnaire with those from the generic one. If the new tool is found to be more useful, it will be made available for future epilepsy treatment studies.