Estimation of Societal Values of Health States Preferences at the National Level for Low- and Middle-Income Countries [Editor's Choice]



Social preference values of health states are a fundamental input for the preparation of studies in health economics. Several countries have undertaken studies to obtain these values. Our objective was to conduct a structured and systematic literature review of articles that calculates this set of representative values at the national level in low- and middle-income countries (LMICs).


In this systematic review, we searched the Embase, MEDLINE, Ovid, SciELO, and LILACS databases, among others, for studies published up to June 2022 that estimated nationally representative health states preferences values for LMICs. We summarized the information qualitatively and assessed the risk of bias in each article using the consensus-based standards for selecting health measurement instruments checklist tool.


Of the 23 663 articles identified, 35 studies were eligible for inclusion. The studies were from 19 countries in Latin-American, Europe, Africa, and Asia. No studies were found for low-income countries. The most commonly applied generic instrument for measuring health-related quality of life was the 5-level version of EQ-5D and 3-level version of EQ-5D. Preference was given to face-to-face administration of these instruments. The sociodemographic variables with the most significant negative correlation versus utility were older adults, marital status (widowed or divorced), and low educational level and income.


Worldwide, there have been few studies that have estimated, in a nationally representative manner, the social values of health states preferences in LMICs. We consider the local estimate of this set of societal values relevant for any society to improve decision making in allocating resources in health budgets.


Oscar Espinosa Michael F. Drummond Luis-Esteban Orozco Angélica Ordóñez Daysi Sanmartín Laura Mora Jessica Ochalek

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