Valuing health-related quality of life: An EQ-5D-5L value set for England

Nancy J Devlin, Koonal K Shah, Yan Feng, Brendan Mulhern, Ben van Hout, Nancy J Devlin, Koonal K Shah, Yan Feng, Brendan Mulhern, Ben van Hout

Abstract

A new version of the EQ-5D, the EQ-5D-5L, is available. The aim of this study is to produce a value set to support use of EQ-5D-5L data in decision-making. The study design followed an international research protocol. Randomly selected members of the English general public completed 10 time trade-off and 7 discrete choice experiment tasks in face-to-face interviews. A 20-parameter hybrid model was used to combine time trade-off and discrete choice experiment data to generate values for the 3,125 EQ-5D-5L health states. Valuation data are available for 996 respondents. Face validity of the data has been demonstrated, with more severe health states generally given lower values. Problems with pain/discomfort and anxiety/depression received the greatest weight. Compared to the existing EQ-5D-3L value set, there are considerably fewer "worse than dead" states (5.1%, compared with over one third), and the minimum value is higher. Values range from -0.285 (extreme problems on all dimensions) to 0.950 (for health states 11211 and 21111). Results have important implications for users of the EQ-5D-5L both in England and internationally. Quality-adjusted life year gains from interventions seeking to improve very poor health may be smaller using this value set and may previously have been overestimated.

Keywords: EQ-5D-5L; NICE; PROMs; quality of life; stated preferences.

Conflict of interest statement

NJD, KKS and YF are employees of the Office of Health Economics, a registered charity which received funding from a variety of sources, including the Association of the British Pharmaceutical Industry. All authors are members of the EuroQol Group.

© 2017 The Authors. Health Economics Published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
The EQ‐5D‐5L descriptive system
Figure 2
Figure 2
(a) Example of time trade‐off valuation of health states better than dead (i.e., values ≥ 0). (b) Example of time trade‐off valuation of health states worse than dead (i.e., values ≤ 0) [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
Example discrete choice experiment task [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 4
Figure 4
Distribution of observed time trade‐off values [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 5
Figure 5
Frequency of values in the EQ‐5D (left) and EQ‐5D‐5L (right) value sets [Colour figure can be viewed at wileyonlinelibrary.com]

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