OBJECTIVES : The PROMIS Preference score (PROPr) is a new generic, societal, and preference-based health-related quality of life (HrQoL) score for Quality-adjusted life years (QALY) in cost-effectiveness analyses, promising to overcome limitations of existing legacy measures such as ceiling effects. It is the first HrQoL score using modern instruments based on Item Response Theory (IRT). The PROPr contains seven PROMIS domains: cognition, depression, fatigue, pain, physical function, sleep disturbance, and ability to participate in social roles and activities. It was valuated in US preferences using standard gamble (SG) online interviews. Aim of this study is to measure HrQoL by PROPr in the general population of three European countries and to compare it to HrQoL measured by the EQ-5D-5L index value.

METHODS : We collected PROMIS-29 Profile and EQ-5D-5L in three samples of the general population in the United Kingdom (n=1,509), France (n=1,501), and Germany (n=1,502). For the missing cognition domain in the PROMIS-29 Profile we assumed population average. Descriptive statistical analyses compared both scores across age and gender, their correlation, and distribution over the full range of health.

RESULTS : The mean PROPr (UK 0.48, France 0.54, Germany 0.48; p<0.01) and the mean EQ-5D-5L index value (UK 0.79, France 0.82, Germany 0.88, p<0.01) show significant difference (UK d=0.31; France d=0.29; Germany d=0.39; p<0.01). The Pearson correlation coefficient is similar (UK 0.76; France 0.72; Germany 0.66) compared to 0.53 (95%CI: 0.33; 0.68) in German patients and 0.70 in the US valuation. In all countries, both scores show similar discrimination across gender and age. The PROPr is approximately normally distributed while the EQ-5D-5L index value shows ceiling effects.

CONCLUSIONS : In three independent samples, our analyses consistently confirm earlier results suggesting that PROPr and EQ-5D-5L index value are not equivalent, effecting QALY in cost-effectiveness analyses. Valuation of PROPr in country-specific preferences with time-trade-off (TTO) would make comparison more valid.