OBJECTIVES : The five-level version of the EQ-5D (EQ-5D-5L) was introduced as an improvement on the original three-level version (EQ-5D-3L). To date, six country-specific value sets have been published for EQ-5D-5L and nine U.S. value sets have been published for other instruments. The central aim of this health preference study was the valuation of the EQ-5D-5L on a quality-adjusted life year (QALY) scale from the perspective of U.S. adults.

METHODS : In 2016, 8,222 U.S. respondents from all 50 states and Washington, DC completed a brief online survey including a discrete choice experiment (DCE) with 20 paired comparisons. Each comparison asked respondents, “Which do you prefer?” regarding a pair of alternatives described using EQ-5D-5L and lifespan attributes. On the basis of more than 50 choices on each of the 3,160 pairs, we estimated EQ-5D-5L values on a QALY scale and compared them to the U.S. EQ-5D-3L values and the other country-specific EQ-5D-5L values.

RESULTS : Ranging from –0.287 (55555) to 0.992 (11121) on a QALY scale, the EQ-5D-5L values were similar to the U.S. EQ-5D-3L values. Compared to the U.S. EQ-5D-3L values, the values exhibited greater sensitivity and specificity and higher correlation with the EQ-5D-5L values of other countries, particularly England.

CONCLUSIONS : Like all U.S. valuation studies of other instruments, this study examined the preferences of U.S. adults to produce nationally representative EQ-5D-5L values on a QALY scale. The results demonstrate the advantages of the EQ-5D-5L over its three-level predecessor as a preference-based summary measure of health-related quality of life from the U.S. societal perspective.