Plain Language Summary

What is it about?

The EQ-5D-5L is a questionnaire measuring health-related quality of life across 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 response options, ie, levels of severity, and the EQ-5D-5L was developed to improve on EQ-5D-3L, a previous version with 3 response options per dimension. This study developed a value set for the EQ-5D-5L in the United Kingdom (UK), that assigns numerical values to health states that can calculate quality-adjusted life-years, which can inform evaluations of the cost-effectiveness of treatments. This study collected preference data from the UK public using time trade-off interviews, where participants indicated how many years of life they would trade to avoid impaired health. The research provides a robust, transparent scoring system reflecting current public values, which can be used to inform healthcare decision making in the United Kingdom.

How was the research conducted?

Researchers recruited 1200 representative UK adults from all 4 nations. Participants completed interviews between January and September 2023, with 1102 by videoconference using Zoom and 98 in-person to enhance inclusivity. Each participant valued 10 health states using time trade-off. This established method systematically collects preference data suitable for statistical modeling and has been successfully used to value EQ-5D-5L in over 30 countries.

What were the results?

The study generated a UK value set using a random effects Tobit model. Anxiety/depression and usual activities showed greater impact on health values than in the UK value set of EQ-5D-3L generated in the 1990s. The worst health state value is -0.567, which is comparable to the UK EQ-5D-3L worse state value of -0.594..

Why are the results important?

This value set allows utilities to be generated directly for the EQ-5D-5L using UK preferences. This is advantageous since the EQ-5D-5L has greater sensitivity in capturing health-related quality of life in patient populations than the EQ-5D-3L. These results can be used to inform policy, including health technology appraisals.

What are the strengths and weaknesses of this study?

The main strength is rigorous quality assurance including independent data quality assessment at 5 time points, comprehensive interviewer training, diverse stakeholder input, and offering a choice of interview via videoconference or in-person for representative sampling. One limitation is that the statistical model cannot simultaneously account for all data characteristics of the time trade-off data.

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