Hernandez Alava, M., Wailoo, A. orcid.org/0000-0002-9324-1617, Grimm, S. et al. (7 more authors) (2018) EQ-5D-5L versus EQ-5D-3L: the impact on cost-effectiveness in the United Kingdom. Value in Health, 21 (1). pp. 49-56. ISSN 1098-3015
Abstract
International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Objectives: To model the relationship between the three-level (3L) and the five-level (5L) EuroQol five-dimensional questionnaire and examine how differences have an impact on cost-effectiveness in case studies. Methods: We used two data sets that included the 3L and 5L versions from the same respondents. The EuroQol Group data set (n = 3551) included patients with different diseases and a healthy cohort. The National Data Bank data set included patients with rheumatoid disease (n = 5205). We estimated a system of ordinal regressions in each data set using copula models to link responses of the 3L instrument to those of the 5L instrument and its UK tariff, and vice versa. Results were applied to nine cost-effectiveness studies. Results: Best-fitting models differed between the EuroQol Group and the National Data Bank data sets in terms of the explanatory variables, copulas, and coefficients. In both cases, the coefficients of the covariates and latent factors between the 3L and the 5L instruments were significantly different, indicating that moving between instruments is not simply a uniform re-alignment of the response levels for most dimensions. In the case studies, moving from the 3L to the 5L ca used a decrease of up to 87% in incremental quality-adjusted life-years gained from effective technologies in almost all cases. Incremental cost-effectiveness ratios increased, often substantially. Conversely, one technology with a significant mortality gain saw increased incremental quality-adjusted life-years. Conclusions: The 5L shifts mean utility scores up the utility scale toward full health and compresses them into a smaller range, compared with the 3L. Improvements in quality of life are valued less using the 5L than using the 3L. The 3L and the 5L can produce substantially different estimates of cost-effectiveness. There is no simple proportional adjustment that can be made to reconcile these differences.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 Elsevier. This is an author produced version of a paper subsequently published in Value in Health. Uploaded in accordance with the publisher's self-archiving policy. Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | cost-effectiveness; EQ-5D; health utility |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Funding Information: | Funder Grant number MEDICAL RESEARCH COUNCIL MR/L022575/1 NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE NICE 1151 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 17 Nov 2017 15:22 |
Last Modified: | 14 Dec 2023 09:07 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1016/j.jval.2017.09.004 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:124002 |
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