Elsevier

Value in Health

Volume 22, Issue 1, January 2019, Pages 45-49
Value in Health

Themed Section: Evolution of EuroQoL
Cost-Utility Analysis Using EQ-5D-5L Data: Does How the Utilities Are Derived Matter?

https://doi.org/10.1016/j.jval.2018.05.008Get rights and content
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Abstract

Objectives

To explore how the use of EQ-5D-5L value set and crosswalk from EQ-5D-5L to EQ-5D-3L (and use of 3L value set) would affect cost-effectiveness analysis results for England and six other countries (Canada, the Netherlands, China, Japan, South Korea, and Singapore).

Methods

Individual-level utilities derived from primary 5L data using both value set (5L) and crosswalk (c5L) approaches were applied to three Markov models assessing the cost-effectiveness of hemodialysis (HD) and peritoneal dialysis (PD) for end-stage renal disease (ESRD) patients to estimate incremental quality-adjusted life years (QALYs). The mathematic functions between incremental QALY and utility were derived.

Results

5L- and c5L-based incremental QALYs were similar in the model for non-diabetic patients (range: 1.910–2.149, 1.922–2.121). 5L tends to generate more incremental QALYs than c5L in the model for diabetic patients (range: 1.454–1.633, 1.365–1.568) but fewer incremental QALYs in the model for all ESRD patients (range: 0.290–0.480, 0.315–0.493).

In all models, 5L (c5L) generated more incremental QALYs when Chinese (South Korean) value sets were used. The largest and smallest differences in 5L- and c5L-based incremental QALYs were observed when Chinese and Dutch value sets were used. Incremental QALYs was a positive linear function of both utility of PD and difference in utilities of HD and PD.

Conclusions

The value set and crosswalk approaches may not be used interchangeably in economic evaluation when EQ-5D-5L data are used to estimate utilities. Results of cost-effectiveness analysis using Markov models may be affected by both absolute utilities and their differences.

Keywords

cost-utility analysis
crosswalk
EQ-5D-3L
EQ-5D-5L
value set

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