OBJECTIVES The EuroQoL-Five Dimensions-Five Levels (EQ-5D-5L) questionnaire was introduced in 2009 with the aim of alleviating the EQ-5D-3L questionnaire’s lack of sensitivity to small changes in health status. Since the publication of the EQ-5D-5L United Kingdom value set in 2018, concerns have arisen regarding the new measure’s validity. The National Institute for Health and Care Excellence (NICE) states that technology appraisals (TAs) should continue to use EQ-5D-3L. The aim of this review was to establish if and how EQ-5D-5L is being used in NICE TAs.

METHODS A review of published NICE TAs within tumour-based oncology diseases was conducted. TAs were included if: guidance had been published after January 2018; a company submission was available; and an evidence review group (ERG) critique was available.

RESULTS : Thirty-two TAs were identified; 8 (25%) and 18 (56%) obtained utilities from the EQ-5D-5L and EQ-5D-3L questionnaires, respectively; 4 (13%) used condition specific quality-of-life measures, and in 2 (6%) it was unclear whether 3L or 5L was used. The number of TAs which utilised EQ-5D-5L has almost doubled from 2018 to 2019.

All 8 EQ-5D-5L TAs mapped 5L utilities to 3L utilities using the Van Hout ‘cross-walk’ algorithm; 1 at the request of the ERG (TA528, BMJ-TAG) and 7 prior to the initial submission. Of the 8 TAs, 4 presented sensitivity analyses, all of which demonstrated an improvement in the cost-effectiveness when EQ-5D-5L was used.

CONCLUSIONS : This review suggests that manufacturers are continuing to use EQ-5D-3L over EQ-5D-5L. However, some TAs found that when EQ-5D-5L utilities are used, cost-effectiveness may be improved. Although the use of the EQ-5D-5L questionnaire in appraisals appears to be increasing, its impact on NICE TAs remains limited.