To date there have been no value sets to support the use of EQ-5D-Y (the ‘youth’ version of the EQ-5D patient-reported outcomes measure) in cost-utility analysis. Discrete choice experiments (DCEs) can be used to obtain values on a latent scale, but these values require anchoring at 0 = dead to meet the conventions of quality-adjusted life year (QALY) estimation.  

A new OHE Research Paper, authored by former OHE researcher Koonal Shah and OHE Senior Fellow Nancy Devlin, in collaboration with Juan Manuel Ramos-Goñi and Simone Kreimeier, compares four stated preference methods for anchoring EQ-5D-Y values: visual analogue scale, DCE (with a duration attribute), lag-time time trade-off, and the recently developed ‘location-of-dead’ (LOD) element of the personal utility function (PUF) approach. A sample of adult members of the UK general public valued both EQ-5D-3L health states from an adult perspective (considering their own health) and EQ-5D-Y health states from a child perspective (considering the health of a 10-year-old child). 

Overall, respondents gave lower values under the adult perspective compared to the child perspective, with some variation across methods. Values for health state 33333 (the worst health state defined by the EQ-5D-3L and EQ-5D-Y descriptive systems) tended to be negative for the adult perspective and close to 0 for the child perspective. The paper presents potential criteria for selecting a preferred anchoring method, and discusses the decision-making circumstances under which utilities and QALY estimates for children and adults need to be commensurate in order to achieve allocative efficiency. 

Citation

Shah, K.K., Ramos-Goñi, J.M., Kreimeier, S. and Devlin, N.J., 2020. Anchoring latent scale values for the EQ-5D-Y at 0 = dead. OHE Research Paper. London: Office of Health Economics. Available at: https://www.ohe.org/publications/anchoring-latent-scale-values-eq-5d-y-0-dead