How Far Have We Come With EQ-5D-5L Value Sets? An Updated Systematic Literature Review of 55 Valuation Studies
Author(s)
Annushiah Vasan Thakumar, BSc, PhD1, Tessa Kennedy-Martin, MSc, BA2, Kristina Secnik Boye, MPH, MS, RPh, PhD3, Xin Zhang, PhD4, Bernhard Slaap, PhD5, Michael Herdman, MSc4, Ling Jie Cheng, PhD, MPH, BSN (Hons), RN6.
1School of Pharmacy, Taylor's University, Subang Jaya, Malaysia, 2Kennedy Martin Health Outcomes, Hove, United Kingdom, 3Cardiometabolic Health, Eli Lilly and Company, Greenwood, IN, USA, 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, 5Executive Office, Euroqol Research Foundation, Rotterdam, Netherlands, 6National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
1School of Pharmacy, Taylor's University, Subang Jaya, Malaysia, 2Kennedy Martin Health Outcomes, Hove, United Kingdom, 3Cardiometabolic Health, Eli Lilly and Company, Greenwood, IN, USA, 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, 5Executive Office, Euroqol Research Foundation, Rotterdam, Netherlands, 6National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
OBJECTIVES: EQ-5D is the most widely recommended instrument in guidance from health technology assessments bodies. The presence of multiple value sets within some countries highlights the need to select the most appropriate one. Since the reviews by Rowen et al (2022) and Poudel et al (2022) the number of published EQ-5D-5L value sets has grown substantially. This systematic review updates the evidence base by identifying EQ-5D-5L value sets and comparing their methodologies, valuation techniques, and reporting quality.
METHODS: A systematic literature review was conducted in accordance with PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, the EuroQol website, and grey literature. Studies since inception published up to 7 May 2025 were included if they reported the development of EQ-5D-5L value sets. Data on valuation methods, modelling strategies, and participant characteristics were extracted. Reporting quality was assessed using the CREATE checklist, with ≥80% indicating good quality.
RESULTS: Of the 5,215 records screened, we identified 51 studies that were used to derive 55 value sets, 46 studies were undertaken with the general population, 5 with patients with specific conditions (e.g., cancer, diabetes). Value sets were derived across all World Bank regions (Europe/Central Asia = 23, East Asia/Pacific/South Asia = 16, Latin America/Caribbean/North Africa = 8, Middle East and North Africa/Sub-Saharan Africa =8). Hybrid valuation (TTO + DCE) was most common (51%), with 87.3% using the EQ-VT standardised valuation protocol. Tobit models were frequently used for TTO data; newer studies applied more sophisticated methods including cross-attribute level effects and Bayesian models. Most studies showed good reporting quality though some could be improved in areas such as model selection transparency, response rates, and scoring algorithm details.
CONCLUSIONS: The review provides an important overview of the current state of valuation studies for the EQ-5D-5L, it shows good geographical coverage, methodological rigor and recency of the valuation evidence base.
METHODS: A systematic literature review was conducted in accordance with PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, the EuroQol website, and grey literature. Studies since inception published up to 7 May 2025 were included if they reported the development of EQ-5D-5L value sets. Data on valuation methods, modelling strategies, and participant characteristics were extracted. Reporting quality was assessed using the CREATE checklist, with ≥80% indicating good quality.
RESULTS: Of the 5,215 records screened, we identified 51 studies that were used to derive 55 value sets, 46 studies were undertaken with the general population, 5 with patients with specific conditions (e.g., cancer, diabetes). Value sets were derived across all World Bank regions (Europe/Central Asia = 23, East Asia/Pacific/South Asia = 16, Latin America/Caribbean/North Africa = 8, Middle East and North Africa/Sub-Saharan Africa =8). Hybrid valuation (TTO + DCE) was most common (51%), with 87.3% using the EQ-VT standardised valuation protocol. Tobit models were frequently used for TTO data; newer studies applied more sophisticated methods including cross-attribute level effects and Bayesian models. Most studies showed good reporting quality though some could be improved in areas such as model selection transparency, response rates, and scoring algorithm details.
CONCLUSIONS: The review provides an important overview of the current state of valuation studies for the EQ-5D-5L, it shows good geographical coverage, methodological rigor and recency of the valuation evidence base.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MSR122
Topic
Methodological & Statistical Research, Real World Data & Information Systems, Study Approaches
Topic Subcategory
PRO & Related Methods
Disease
No Additional Disease & Conditions/Specialized Treatment Areas