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A Comparison of PROPr and EQ-5D-5L Value Sets

Author

Listed:
  • Tianxin Pan

    (The University of Melbourne
    Curtin University)

  • Brendan Mulhern

    (University of Technology Sydney)

  • Rosalie Viney

    (University of Technology Sydney)

  • Richard Norman

    (Curtin University)

  • Janel Hanmer

    (University of Pittsburgh)

  • Nancy Devlin

    (The University of Melbourne)

Abstract

Objectives The EQ-5D-5L and its value sets are widely used internationally. However, in the US and elsewhere, there is growing use of PROMIS, which has a value set (PROPr) based on the stated preferences of the US population. This paper aims to compare the characteristics of EQ-5D-5L and PROPr value sets and to highlight potential implications for users. Methods US, Australian and English value sets were used for EQ-5D-5L. PROPr utilities were calculated based on PROMIS-29 + 2. We examined, in each case, (i) the characteristics (e.g. range of values, number of unique values) and distribution of all possible ‘theoretical’ utilities; (ii) dimension/domain importance ranking by the utility of corner states (i.e. health states with the worst level in one domain and the best in all others); (iii) comparisons of utilities for health states hypothesised to be comparable in terms of severity across EQ-5D-5L descriptive systems and PROMIS-29 + 2 domain scores; (iv) the changes in values of adjacent states (i.e. a one-level change in one dimension for EQ-5D-5L and a four-point change in raw scores for PROMIS-29 + 2, with the other dimensions held constant) for dimensions hypothesised to overlap conceptually or be correlated between the two instruments. Results EQ-5D-5L and PROPr utilities differ systematically. First, the US EQ-5D-5L utilities range from − 0.573 to 1, whereas PROPr values for PROMIS-29 + 2 range from − 0.022 to 0.954. Second, in the US (and English) EQ-5D-5L value sets, pain is the most important dimension whereas in PROPr pain is one of the least important (apart from sleep disturbance). Third, classified based on severity across EQ-5D-5L descriptive systems and PROMIS-29 + 2 domain scores, PROPr has substantially lower values than EQ-5D-5L values for comparable ‘mild’ health states, but higher values for more ‘severe’ health states. Last, when one dimension is considered across its best to worst levels and all other dimensions are held constant at their best or moderate level, in EQ-5D-5L value sets, the greatest changes in utility occur between levels 3 and 4 (moderate and severe) problems; in PROPr that occurred between the most severe states and their descriptively adjacent health states. Conclusion There are very considerable differences between US EQ-5D-5L and PROPr utilities, despite both in principle representing utility on the same scale anchored at 0 and 1 and both representing the preferences of the US general public. It is important for decision makers and clinical triallists to be aware of these differences. Further work is needed to assess the impact of these differences in value sets using population and patient data, and in longitudinal settings.

Suggested Citation

  • Tianxin Pan & Brendan Mulhern & Rosalie Viney & Richard Norman & Janel Hanmer & Nancy Devlin, 2022. "A Comparison of PROPr and EQ-5D-5L Value Sets," PharmacoEconomics, Springer, vol. 40(3), pages 297-307, March.
    • Handle: RePEc:spr:pharme:v:40:y:2022:i:3:d:10.1007_s40273-021-01109-3
    DOI: 10.1007/s40273-021-01109-3
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    References listed on IDEAS

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    1. David Parkin & Nigel Rice & Nancy Devlin, 2010. "Statistical Analysis of EQ-5D Profiles: Does the Use of Value Sets Bias Inference?," Medical Decision Making, , vol. 30(5), pages 556-565, September.
    2. Richard Norman & Paula Cronin & Rosalie Viney, 2013. "A Pilot Discrete Choice Experiment to Explore Preferences for EQ-5D-5L Health States," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 287-298, June.
    3. Barry Dewitt & David Feeny & Baruch Fischhoff & David Cella & Ron D. Hays & Rachel Hess & Paul A. Pilkonis & Dennis A. Revicki & Mark S. Roberts & Joel Tsevat & Lan Yu & Janel Hanmer, 2018. "Estimation of a Preference-Based Summary Score for the Patient-Reported Outcomes Measurement Information System: The PROMIS®-Preference (PROPr) Scoring System," Medical Decision Making, , vol. 38(6), pages 683-698, August.
    4. Nancy J. Devlin & Koonal K. Shah & Yan Feng & Brendan Mulhern & Ben van Hout, 2018. "Valuing health‐related quality of life: An EQ‐5D‐5L value set for England," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 7-22, January.
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    1. Finch, Aureliano Paolo & Mulhern, Brendan, 2022. "Where do measures of health, social care and wellbeing fit within a wider measurement framework? Implications for the measurement of quality of life and the identification of bolt-ons," Social Science & Medicine, Elsevier, vol. 313(C).

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