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Econometric modelling of multiple self-reports of health states: The switch from EQ-5D-3L to EQ-5D-5L in evaluating drug therapies for rheumatoid arthritis

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  • Hernández-Alava, Mónica
  • Pudney, Stephen

Abstract

EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but the consequences of this change are uncertain. We develop a multi-equation ordinal response model incorporating a copula specification with normal mixture marginals to analyse joint responses to EQ-5D-3L and EQ-5D-5L in a survey of people with rheumatic disease, and use it to generate mappings between the alternative descriptive systems. We revisit a major cost-effectiveness study of drug therapies for rheumatoid arthritis, mapping the original EQ-5D-3L measure onto a 5L valuation basis. Working within a comprehensive, flexible econometric framework, we find that use of simpler restricted specifications can make very large changes to cost-effectiveness estimates with serious implications for decision-making.

Suggested Citation

  • Hernández-Alava, Mónica & Pudney, Stephen, 2017. "Econometric modelling of multiple self-reports of health states: The switch from EQ-5D-3L to EQ-5D-5L in evaluating drug therapies for rheumatoid arthritis," Journal of Health Economics, Elsevier, vol. 55(C), pages 139-152.
  • Handle: RePEc:eee:jhecon:v:55:y:2017:i:c:p:139-152
    DOI: 10.1016/j.jhealeco.2017.06.013
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    References listed on IDEAS

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    1. Yan Feng & Nancy J. Devlin & Koonal K. Shah & Brendan Mulhern & Ben van Hout, 2018. "New methods for modelling EQ‐5D‐5L value sets: An application to English data," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 23-38, January.
    2. Mónica Hernández-Alava & Stephen Pudney, 2016. "bicop: A command for fitting bivariate ordinal regressions with residual dependence characterized by a copula function and normal mixture marginals," Stata Journal, StataCorp LP, vol. 16(1), pages 159-184, March.
    3. John Brazier & Yaling Yang & Aki Tsuchiya & Donna Rowen, 2010. "A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 215-225, April.
    4. Anastasios Panagiotelis & Claudia Czado & Harry Joe, 2012. "Pair Copula Constructions for Multivariate Discrete Data," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 107(499), pages 1063-1072, September.
    5. Caterina Conigliani & Andrea Manca & Andrea Tancredi, 2015. "Prediction of patient-reported outcome measures via multivariate ordered probit models," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 178(3), pages 567-591, June.
    6. 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.
    7. John Brazier & Aki Tsuchiya, 2015. "Improving Cross-Sector Comparisons: Going Beyond the Health-Related QALY," Applied Health Economics and Health Policy, Springer, vol. 13(6), pages 557-565, December.
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    Cited by:

    1. Paul Anand & Laurence S. J. Roope & Anthony J. Culyer & Ron Smith, 2020. "Disability and multidimensional quality of life: A capability approach to health status assessment," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 748-765, July.

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    More about this item

    Keywords

    EQ-5D; Ordinal response; Copula; Mixture models; Rheumatoid arthritis; Mapping; Cost-effectiveness;
    All these keywords.

    JEL classification:

    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • C83 - Mathematical and Quantitative Methods - - Data Collection and Data Estimation Methodology; Computer Programs - - - Survey Methods; Sampling Methods
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General

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