Estimating health utility associated with mental well-being: mapping GHQ-12 responses onto EQ-5D-5L

Abstract

citation ID: ckaf161.006 Cost effectiveness of improving HPV vaccine uptake in This contributes to preventable disease burdens and widening health inequities. Within the framework of the RIVER-EU project, interventions were designed to address health system barriers to vaccine access. This study evaluates the cost-effectiveness of one of these interventions aimed at improving HPV vaccine uptake among the underserved populations in the Netherlands focusing on the Turkish and Moroccan communities. Methods: A gender-neutral static cohort model considering six HPV-related cancers was developed to simulate the lifetime health and economic impacts of the intervention. Input parameters were sourced from national databases and published literature. Primary outcome measures were cancer cases and deaths averted and the incremental cost effectiveness ratio (ICER). Costs were adjusted to 2024 euros using the Dutch consumer price index (CPI), with discount rates of 3% and 1.5% applied on costs and effects respectively. Probabilistic and one-way sensitivity analyses assessed model and parameter uncertainty. Results: Preliminary results estimated discounted incremental costs and QALYs of e1.04million and 627 QALYs respectively, resulting in an ICER of e1665 per QALY. These early results reflect reductions in HPV-related cancer cases and deaths from increased vaccination. Sensitivity analyses revealed that the model was most influenced by and intervention costs and vaccination coverage. Final results incorporating updated parameters will be presented during the conference. Conclusions: Implementing targeted interventions to improve HPV vaccine uptake in underserved populations has the potential to be cost-effective while advancing health equity. These findings support scaling such strategies to close vaccination gaps and reduce HPV-related disease burdens. Key messages: • Targeted interventions in marginalized communities can be cost-effective. • Improving HPV vaccine uptake in underserved populations promotes health equity. Abstract citation ID: ckaf161.007 Background: Mental well-being measures are common in population surveys but cannot be directly used for utility-based economic evaluations. Existing mapping studies, mostly pre-Covid-19, relied on linear regression, and may not reflect individuals' evolving preferences on quality of life. This study explores methods to estimate health utility associated with mental well-being, by linking EQ-5D-5L and GHQ-12 responses collected in a large population sample. Methods: We used data from 12701 respondents participating in the 46th Wave of the Belgian "Great Corona Study", in March 2022. We compared direct methods (linear and inflated beta regression) that map source responses directly to utility values, with indirect methods that estimate responses for each EQ-5D-5L dimension using non-parametric or ordered logistic regression before generating utilities. Regression models used either individual GHQ-12 items or the total score as the dependent variable, controlling for sociodemo-graphic factors. Model performance was assessed using root mean squared error (RMSE). Results: Greater GHQ-12 distress, at both item and total score levels was linked with greater problems across EQ-5D dimensions and lower utility values. RMSE ranged from 0.142 (linear model with GHQ-12 items) to 0.157 (beta inflated model with GHQ-12 scores), with linear and ordered logistic models performing best, although linear models performed worse than beta when estimating values at the lower end. Despite violated normality assumptions, linear regression yielded the lowest RMSE. Indirect mapping is conceptually more robust, as it aligns closely with the dimensional structure of EQ-5D-5L and minimises variations associated with the use of different value sets. Conclusions: This study provides up-to-date algorithms for mapping mental well-being data to health utility values. The mapping can enable the integration of mental health data for use in QALY-based economic evaluations, where utility data are not available. Key messages: • This study provides updated algorithms for estimating health utility values from mental well-being data, enabling the integration of mental health measures into QALY-based economic evaluations. • Choosing the best mapping method involves balancing predictive performance with conceptual appropriateness and simplicity.