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Is EQ-5D-5L Better Than EQ-5D-3L? A Head-to-Head Comparison of Descriptive Systems and Value Sets from Seven Countries

Author

Listed:
  • Mathieu F. Janssen

    (Erasmus MC, Erasmus University)

  • Gouke J. Bonsel

    (Erasmus MC, Erasmus University
    UMC Utrecht, University of Utrecht)

  • Nan Luo

    (National University of Singapore)

Abstract

Objective This study describes the first empirical head-to-head comparison of EQ-5D-3L (3L) and EQ-5D-5L (5L) value sets for multiple countries. Methods A large multinational dataset, including 3L and 5L data for eight patient groups and a student cohort, was used to compare 3L versus 5L value sets for Canada, China, England/UK (5L/3L, respectively), Japan, The Netherlands, South Korea and Spain. We used distributional analyses and two methods exploring discriminatory power: relative efficiency as assessed by the F statistic, and an area under the curve for the receiver-operating characteristics approach. Differences in outcomes were explored by separating descriptive system effects from valuation effects, and by exploring distributional location effects. Results In terms of distributional evenness, efficiency of scale use and the face validity of the resulting distributions, 5L was superior, leading to an increase in sensitivity and precision in health status measurement. When compared with 5L, 3L systematically overestimated health problems and consequently underestimated utilities. This led to bias, i.e. over- or underestimations of discriminatory power. Conclusion We conclude that 5L provides more precise measurement at individual and group levels, both in terms of descriptive system data and utilities. The increased sensitivity and precision of 5L is likely to be generalisable to longitudinal studies, such as in intervention designs. Hence, we recommend the use of the 5L across applications, including economic evaluation, clinical and public health studies. The evaluative framework proved to be useful in assessing preference-based instruments and might be useful for future work in the development of descriptive systems or health classifications.

Suggested Citation

  • Mathieu F. Janssen & Gouke J. Bonsel & Nan Luo, 2018. "Is EQ-5D-5L Better Than EQ-5D-3L? A Head-to-Head Comparison of Descriptive Systems and Value Sets from Seven Countries," PharmacoEconomics, Springer, vol. 36(6), pages 675-697, June.
  • Handle: RePEc:spr:pharme:v:36:y:2018:i:6:d:10.1007_s40273-018-0623-8
    DOI: 10.1007/s40273-018-0623-8
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    References listed on IDEAS

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    1. Nigel Rice & Silvana Robone & Peter Smith, 2011. "Analysis of the validity of the vignette approach to correct for heterogeneity in reporting health system responsiveness," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 141-162, April.
    2. Aki Tsuchiya & Shunya Ikeda & Naoki Ikegami & Shuzo Nishimura & Ikuro Sakai & Takashi Fukuda & Chisato Hamashima & Akinori Hisashige & Makoto Tamura, 2002. "Estimating an EQ‐5D population value set: the case of Japan," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 341-353, June.
    3. David Parkin & Nancy Devlin & Yan Feng, 2016. "What Determines the Shape of an EQ-5D Index Distribution?," Medical Decision Making, , vol. 36(8), pages 941-951, November.
    4. Mark Oppe & Kim Rand-Hendriksen & Koonal Shah & Juan M. Ramos‐Goñi & Nan Luo, 2016. "EuroQol Protocols for Time Trade-Off Valuation of Health Outcomes," PharmacoEconomics, Springer, vol. 34(10), pages 993-1004, October.
    5. 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.
    6. L. M. Lamers & J. McDonnell & P. F. M. Stalmeier & P. F. M. Krabbe & J. J. V. Busschbach, 2006. "The Dutch tariff: results and arguments for an effective design for national EQ‐5D valuation studies," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1121-1132, October.
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    Cited by:

    1. Nancy Devlin & John Brazier & A. Simon Pickard & Elly Stolk, 2018. "3L, 5L, What the L? A NICE Conundrum," PharmacoEconomics, Springer, vol. 36(6), pages 637-640, June.
    2. Zsombor Zrubka & Zsuzsanna Beretzky & Zoltán Hermann & Valentin Brodszky & László Gulácsi & Fanni Rencz & Petra Baji & Dominik Golicki & Valentina Prevolnik-Rupel & Márta Péntek, 2019. "A comparison of European, Polish, Slovenian and British EQ-5D-3L value sets using a Hungarian sample of 18 chronic diseases," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 119-132, June.
    3. Carlos King Ho Wong & Prudence Wing Hang Cheung & Nan Luo & Jason Pui Yin Cheung, 2019. "A head-to-head comparison of five-level (EQ-5D-5L-Y) and three-level EQ-5D-Y questionnaires in paediatric patients," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 647-656, July.
    4. Becky Pennington & Monica Hernandez-Alava & Stephen Pudney & Allan Wailoo, 2019. "The Impact of Moving from EQ-5D-3L to -5L in NICE Technology Appraisals," PharmacoEconomics, Springer, vol. 37(1), pages 75-84, January.
    5. Nancy J. Devlin & Koonal K. Shah & Brendan J. Mulhern & Krystallia Pantiri & Ben van Hout, 2019. "A new method for valuing health: directly eliciting personal utility functions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 257-270, March.

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