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Within the OMERACT Economics Workgroup, an initiative was started to work towards consensus on the approach to calculate quality-adjusted life-years (QALY) in rheumatology. We report on a first meeting May 7, 2008, in Toronto attended by rheumatologists and experts in QALY. Following a summary of an international QALY workshop of pharmacoeconomists conducted under the umbrella of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), participating experts identified a series of high-level generic principles to be considered for QALY estimations. The OMERACT workgroup then addressed specific issues rheumatologists should concentrate on in research to build consensus on QALY in rheumatology; discussion was based on results of a Web-based survey, conducted prior to the meeting, to identify attributes of a QALY considered important and approaches considered suitable for the QALY estimations in rheumatology. One priority was to further explore indirect approaches to QALY estimation as representation of patients' preference for health in clinical decisions and to explore the additional value of patients' preferences versus societal preferences in allocation decisions. The role of the different descriptive systems and their influence on the QALY, the role of the visual analog scale to value preferences, and comparison of methods to integrate utility over time were also identified as research priorities. Approaches should be easy to apply, easy to understand by different parties, reproducible, and sensitive to change.

The OMERACT Initiative. Towards a Reference Approach to Derive QALY for Economic Evaluations in Rheumatology