VALUE SET PLAUSIBLE? EVIDENCE FROM RECENT FRENCH HTA APPRAISALS
Author(s)
Julie Chevalier, MASc, PhD1, Bertrand Tehard, MSc, PhD2.
1Scientific Director, Vyoo Agency, Paris, France, 2Vyoo Agency, Paris, France.
1Scientific Director, Vyoo Agency, Paris, France, 2Vyoo Agency, Paris, France.
OBJECTIVES: EQ-5D-5L was developed to improve the sensitivity of the EQ-5D-3L. Before publication of the French EQ-5D-5L value set (Andrade et al.), utilities were commonly estimated using the van Hout crosswalk. Following methodological concerns regarding the original EQ-5D-5L valuation protocol, NICE commissioned a new UK valuation study using a revised protocol. The performance of the French value set has not yet been explored in HTA appraisals. The objective is to provide an overview of the EQ-5D-5L data used in French HTA appraisals and to discuss the need of a new valuation study.
METHODS: CEESP appraisals published between January 2025 and June 2026 were reviewed. Appraisals reporting utilities calculated using both valuation methods were included. Utility values, differences between health states, comparison with French population norms, and impacts on incremental cost-effectiveness ratios (ICERs) were extracted.
RESULTS: Four oncology appraisals met the inclusion criteria. All of them relate to oncology treatment and describe patient pathway with progression-free and progressed health states. Utilities estimated using Andrade were high (0.84-0.95), with progression-free values ranging from 0.89 to 0.95 and frequently exceeding French population norms (0.89-0.91). By contrast, utilities estimated using van Hout were lower (0.51-0.84) and below corresponding population norms (0.81-0.85). Utility decrements associated with progression were small with Andrade (0.02-0.04) but larger with van Hout (0.00-0.14). Replacing Andrade utilities with van Hout utilities increased reported ICERs by 13% to 26%.
CONCLUSIONS: The French EQ-5D-5L value-set consistently produced higher utilities and smaller utility decrements than the van Hout crosswalk, leading to substantial differences in cost-effectiveness results. The observation that several advanced cancer health states were assigned utilities exceeding those of the general population raises questions about the validity of the current French value set. Pending a new French valuation study, the van Hout crosswalk should be preferred in French HTA submissions.
METHODS: CEESP appraisals published between January 2025 and June 2026 were reviewed. Appraisals reporting utilities calculated using both valuation methods were included. Utility values, differences between health states, comparison with French population norms, and impacts on incremental cost-effectiveness ratios (ICERs) were extracted.
RESULTS: Four oncology appraisals met the inclusion criteria. All of them relate to oncology treatment and describe patient pathway with progression-free and progressed health states. Utilities estimated using Andrade were high (0.84-0.95), with progression-free values ranging from 0.89 to 0.95 and frequently exceeding French population norms (0.89-0.91). By contrast, utilities estimated using van Hout were lower (0.51-0.84) and below corresponding population norms (0.81-0.85). Utility decrements associated with progression were small with Andrade (0.02-0.04) but larger with van Hout (0.00-0.14). Replacing Andrade utilities with van Hout utilities increased reported ICERs by 13% to 26%.
CONCLUSIONS: The French EQ-5D-5L value-set consistently produced higher utilities and smaller utility decrements than the van Hout crosswalk, leading to substantial differences in cost-effectiveness results. The observation that several advanced cancer health states were assigned utilities exceeding those of the general population raises questions about the validity of the current French value set. Pending a new French valuation study, the van Hout crosswalk should be preferred in French HTA submissions.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE455
Topic
Economic Evaluation, Health Technology Assessment, Patient-Centered Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas