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Head-to-Head Comparison of EQ‐5D‐3L and EQ‐5D‐5L Health Values


  • Anna Selivanova

    (University of Groningen, University Medical Center Groningen)

  • Erik Buskens

    (University of Groningen, University Medical Center Groningen)

  • Paul F. M. Krabbe

    (University of Groningen, University Medical Center Groningen)


Background The EQ-5D is a widely used preference-based instrument to measure health-related quality of life. Some methodological drawbacks of its three-level version (EQ-5D-3L) prompted development of a new format (EQ-5D-5L). There is no clear evidence that the new format outperforms the standard version. Objective The objective of this study was to make a head-to-head comparison of the EQ-5D-3L and EQ-5D-5L in a discrete choice model setting giving special attention to the consistency and logical ordering of coefficients for the attribute levels and to the differences in health-state values. Methods Using efficient designs, 240 pairs of EQ-5D-3L health states and 240 pairs of EQ-5D-5L health states were generated in a pairwise choice format. The study included 3698 Dutch general population respondents, analyzed their responses using a conditional logit model, and compared the values elicited by EQ-5D-3L and EQ-5D-5L for different health states. Results No inconsistencies or illogical ordering of level coefficients were observed in either version. The proportion of severe health states with low values was higher in the EQ-5D-5L than in the EQ-5D-3L, and the proportion of mild/moderate states was lower in the EQ-5D-5L than in the EQ-5D-3L. Moreover, differences were observed in the relative weights of the attributes. Conclusion Overall distribution of health-state values derived from a large representative sample using the same measurement framework for both versions showed differences between the EQ-5D-3L and EQ-5D-5L. However, even small differences in the phrasing (language) of the descriptive system or in the valuation protocol can produce differences in values between these two versions.

Suggested Citation

  • Anna Selivanova & Erik Buskens & Paul F. M. Krabbe, 2018. "Head-to-Head Comparison of EQ‐5D‐3L and EQ‐5D‐5L Health Values," PharmacoEconomics, Springer, vol. 36(6), pages 715-725, June.
  • Handle: RePEc:spr:pharme:v:36:y:2018:i:6:d:10.1007_s40273-018-0647-0
    DOI: 10.1007/s40273-018-0647-0

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    References listed on IDEAS

    1. Brendan Mulhern & Yan Feng & Koonal Shah & Mathieu F. Janssen & Michael Herdman & Ben Hout & Nancy Devlin, 2018. "Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets," PharmacoEconomics, Springer, vol. 36(6), pages 699-713, June.
    2. McKenzie, Lynda & Cairns, John & Osman, Liesl, 2001. "Symptom-based outcome measures for asthma: the use of discrete choice methods to assess patient preferences," Health Policy, Elsevier, vol. 57(3), pages 193-204, September.
    3. 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.
    4. Rosalie Viney & Richard Norman & John Brazier & Paula Cronin & Madeleine T. King & Julie Ratcliffe & Deborah Street, 2014. "An Australian Discrete Choice Experiment To Value Eq‐5d Health States," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 729-742, June.
    5. 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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    1. Lei Si & Liudan Tu & Ya Xie & Gang Chen & Mickaël Hiligsmann & Mingcan Yang & Yanli Zhang & Xi Zhang & Yutong Jiang & Qiujing Wei & Jieruo Gu & Andrew J. Palmer, 2022. "Evaluating Health Related Quality of Life in Older People at Risk of Osteoporotic Fracture: A Head-to-Head Comparison of the EQ-5D-5L and AQoL-6D," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 809-824, April.

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