MSR7 Multiplicative With Linear Transformation (MLT): An Improvement on the Multiplicative Method for Age and Sex Adjustment of Utilities?

The NICE methods guide update explicitly recommends adjustment of utilities for age using the multiplicative method. However, little discussion is provided in the new guidance or in the literature on potential limitations of the multiplicative method in terms of scaling, bounding and generalisability across different preference-based utility measures (PBUMs). Furthermore, the multiplicative method is unsuitable for handling negative health state utility values (HSUVs) or preventing unobtainable HSUVs for PBUMs where the lowest attainable utility value excluding death (ulower_alive) is above 0. We aimed to explore the use of linear transformation to address limitations with the standard multiplicative method.