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        An International Comparison of EQ-5D-5L and EQ-5D-3L for Use in Cost-Effectiveness Analysis

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        ViH_manuscript_final.pdf (PDF, 250Kb)(embargoed until 06/01/2022)
        Author
        Wailoo, Allan J
        Alava, Monica Hernandez
        Pudney, Stephen
        Barton, Garry
        O’Dwyer, John
        Gomes, Manuel
        Irvine, Lisa
        Meads, David
        Sadique, Zia
        Attention
        2299/23695
        Abstract
        Objectives: To estimate the impact of using EQ5D-5L (5L) compared with EQ5D-3L (3L) in cost-effectiveness analyses in 6 countries with 3L and 5L values: Germany, Japan, Korea, The Netherlands, China, and Spain. Methods: Eight cost-effectiveness analyses based on clinical studies with 3L provided 11 pairwise comparisons. We estimated cost-effectiveness by applying the appropriate country values for 3L to observed responses. We re-estimated cost-effectiveness for each country by predicting the 5L tariff score for each respondent, for each country, using a previously published mapping method. We compared results in terms of impact on estimated incremental quality-adjusted life-year (QALY) gain and cost-effectiveness ratios. Results: For most countries the impact of moving from 3L to 5L is to lower the incremental QALY gain in the majority of comparisons. The only exception to this was Japan, where 4 out of 11 cases (37%) saw lower QALYs gained when using 5L. The mean and median reductions in health gain, in those case studies where 5L does lead to lower health gain, are largest in The Netherlands (84% mean reduction, 41% median reduction), Germany (68% and 27%), and Spain (30% and 31%). For most countries, those studies where 5L leads to lower health gain see larger reductions than the gains in studies showing the opposite tendency. Conclusions: Overall, 3L and 5L are not interchangeable in these countries. Differences between results are large, but the direction of change can be unpredictable. These findings should prompt further investigation into the reasons for differences.
        Publication date
        2021-01-06
        Published in
        Value in Health
        Published version
        https://doi.org/10.1016/j.jval.2020.11.012
        Other links
        http://hdl.handle.net/2299/23695
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