Can EQ-5D-5L Discriminate the Clinical Severity of Asthma?
Author(s)
Shinichi Noto, PhD1, Kensuke Moriwaki, BS, MS, PhD2, Yasuhiro Hagiwara, MPH, PhD3, Tsuguo Iwatani, MD, PhD4, Yoshimi Suzukamo, PhD5, Kosuke MORIMOTO, BS5, Tomomi Maeda, BS5, Kojiro Shimozuma, PhD, MD5.
1Professor, Niigata University of Health and Welfare, Niigata, Japan, 2Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organ, Ritsumeikan University, Kyoto, Japan, 3Department of Biostatistics, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, 4Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Japan, 5Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Ritsumeikan University, Kyoto, Japan.
1Professor, Niigata University of Health and Welfare, Niigata, Japan, 2Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organ, Ritsumeikan University, Kyoto, Japan, 3Department of Biostatistics, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, 4Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Japan, 5Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Ritsumeikan University, Kyoto, Japan.
OBJECTIVES: This study aimed to investigate whether the EQ-5D-5L, commonly used in cost-effectiveness analyses for health technology assessments (HTAs), can discriminate the clinical severity of asthma.
METHODS: A pre-screening survey was conducted via a large web-based disease panel to minimize bias related to asthma control status. Participants were categorized into "mild" and "moderate or severe" asthma groups. Recruitment continued until each group included 350 participants. Asthma severity was assessed using the Asthma Control Questionnaire (ACQ) -6, and the two clinical severity groups (well-controlled and poorly controlled groups) were classified based on a cutoff score of 1.5. Patient-reported outcome (PRO) was measured by the Asthma Quality of Life Questionnaire (AQLQ), and health-state utility value was measured by the EQ-5D-5L, whose response scores were converted into utility values using a Japanese value set. The comparison of the two measures was examined by correlation and the rate of decline by severity.
RESULTS: The final analysis included 710 participants. The mean AQLQ score was 6.30 ± 0.64 in the well-controlled group and 4.77 ± 1.02 in the poorly controlled group. The mean EQ-5D-5L utility value was 0.892 ± 0.139 and 0.789 ± 0.180, respectively. The ACQ-6 showed a strong correlation with the AQLQ (r = −0.814) and a moderate correlation with the EQ-5D-5L (r = −0.352). In comparing asthma severity, the AQLQ score was 24.3% lower, and the EQ-5D-5L utility value was 11.5% lower in the poorly controlled group than the well-controlled group.
CONCLUSIONS: The EQ-5D-5L may not fully capture asthma severity, suggesting caution is warranted when applying it in cost-effectiveness analysis for HTA.
METHODS: A pre-screening survey was conducted via a large web-based disease panel to minimize bias related to asthma control status. Participants were categorized into "mild" and "moderate or severe" asthma groups. Recruitment continued until each group included 350 participants. Asthma severity was assessed using the Asthma Control Questionnaire (ACQ) -6, and the two clinical severity groups (well-controlled and poorly controlled groups) were classified based on a cutoff score of 1.5. Patient-reported outcome (PRO) was measured by the Asthma Quality of Life Questionnaire (AQLQ), and health-state utility value was measured by the EQ-5D-5L, whose response scores were converted into utility values using a Japanese value set. The comparison of the two measures was examined by correlation and the rate of decline by severity.
RESULTS: The final analysis included 710 participants. The mean AQLQ score was 6.30 ± 0.64 in the well-controlled group and 4.77 ± 1.02 in the poorly controlled group. The mean EQ-5D-5L utility value was 0.892 ± 0.139 and 0.789 ± 0.180, respectively. The ACQ-6 showed a strong correlation with the AQLQ (r = −0.814) and a moderate correlation with the EQ-5D-5L (r = −0.352). In comparing asthma severity, the AQLQ score was 24.3% lower, and the EQ-5D-5L utility value was 11.5% lower in the poorly controlled group than the well-controlled group.
CONCLUSIONS: The EQ-5D-5L may not fully capture asthma severity, suggesting caution is warranted when applying it in cost-effectiveness analysis for HTA.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD50
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)