IMPACT OF THE NEW UK EQ-5D-5L VALUE SET ON HEALTH STATE UTILITY VALUES: A MULTI-COUNTRY COMPARISON ACROSS DISEASE GROUPS
Author(s)
Irene Santi, PhD1, André Pestana Andrade, MSc2, Lydia Walder, MSc2, Jack Williams, DPhil3.
1HTA and Modelling Science Lead, Astrazeneca, Barcelona, Spain, 2AstraZeneca, Barcelona, Spain, 3AstraZeneca UK Ltd, Cambridge, United Kingdom.
1HTA and Modelling Science Lead, Astrazeneca, Barcelona, Spain, 2AstraZeneca, Barcelona, Spain, 3AstraZeneca UK Ltd, Cambridge, United Kingdom.
OBJECTIVES: NICE is adopting the directly elicited EQ-5D-5L value set for the UK (Rowen et al., 2026), replacing the Hernández-Alava crosswalk that maps EQ-5D-5L responses to EQ-5D-3L utilities. Evidence suggests non-uniform differences between these tariffs across the utility scale, but cross-country implications remain unclear. This study aimed to quantify changes in utility (Δ = 5L value set - 3L crosswalk) and examine variation by baseline utility, disease group (cancer vs non-cancer), and country.
METHODS: Data were drawn from the Multi Instrument Comparison project, a cross-national online survey across eight disease areas in six countries (Australia, Canada, Germany, Norway, UK, USA). The sample included 5,710 adults, excluding those with hearing loss. EQ-5D-5L responses were scored using both value sets. Mean individual-level differences were estimated overall, by disease group, and by country. A sensitivity analysis stratified results by quartiles of baseline Hernández utilities to assess non-linearity.
RESULTS: The Rowen tariff yielded systematically higher utilities (Δ = 0.086, SD = 0.059, 95% CI: 0.084-0.087), with 96.6% of patients showing higher utility. Differences varied non-linearly, peaking in the second quartile (0.61 to <0.74; mean Δ = 0.128) and diminishing at higher utility levels. Mean differences were comparable between cancer (Δ = 0.088) and non-cancer patients (Δ = 0.085), suggesting effects are driven by baseline severity rather than disease aetiology. Non-linear patterns were consistent across all six countries, with mean Δ ranging from 0.085 to 0.093.
CONCLUSIONS: The utility change when moving from the Hernández crosswalk to the Rowen value set is non-linear, peaking in the 0.61-0.74 range, minimal at extremes, and consistent across countries and disease groups. For health technology assessments, the impact of the new tariff will vary depending on where patients sit on the utility scale, with the greatest change for those with baseline utilities between approximately 0.6 and 0.75.
METHODS: Data were drawn from the Multi Instrument Comparison project, a cross-national online survey across eight disease areas in six countries (Australia, Canada, Germany, Norway, UK, USA). The sample included 5,710 adults, excluding those with hearing loss. EQ-5D-5L responses were scored using both value sets. Mean individual-level differences were estimated overall, by disease group, and by country. A sensitivity analysis stratified results by quartiles of baseline Hernández utilities to assess non-linearity.
RESULTS: The Rowen tariff yielded systematically higher utilities (Δ = 0.086, SD = 0.059, 95% CI: 0.084-0.087), with 96.6% of patients showing higher utility. Differences varied non-linearly, peaking in the second quartile (0.61 to <0.74; mean Δ = 0.128) and diminishing at higher utility levels. Mean differences were comparable between cancer (Δ = 0.088) and non-cancer patients (Δ = 0.085), suggesting effects are driven by baseline severity rather than disease aetiology. Non-linear patterns were consistent across all six countries, with mean Δ ranging from 0.085 to 0.093.
CONCLUSIONS: The utility change when moving from the Hernández crosswalk to the Rowen value set is non-linear, peaking in the 0.61-0.74 range, minimal at extremes, and consistent across countries and disease groups. For health technology assessments, the impact of the new tariff will vary depending on where patients sit on the utility scale, with the greatest change for those with baseline utilities between approximately 0.6 and 0.75.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA84
Topic
Economic Evaluation, Health Technology Assessment, Methodological & Statistical Research
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Oncology, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)