Differences between hypothetical and experience-based value sets for EQ-5D used in Sweden: Implications for decision makers.
OBJECTIVE
A number of value sets are available today for converting EQ-5D questionnaire responses to quality-adjusted life year-weights used in health economic evaluations. The aim of this study is to analyse the differences between the commonly used hypothetical UK value set and the newly introduced Swedish experience-based value set and to evaluate health economic implications of such differences on policy decisions.


METHODS
Differences between the two value sets were studied using two methods: a comparison of health states and improvements as well as an empirical comparison. In the comparison of health states and improvements, the valuations of all EQ-5D states and all pure improvements were compared. In the empirical study, a database of 23,925 individuals was used to identify patient groups that could be affected by the implementation of the Swedish experience-based value set.


RESULTS
The comparison of health states and possible improvements showed that only three health states were assigned a lower quality-adjusted life year-weight and most improvements were given smaller absolute values if the experience-based value set was used. The empirical comparison showed that severe conditions were assigned higher values when using the experience-based value set.


CONCLUSIONS
The Swedish experience-based value set seems to render a higher estimated level of health-related quality of life in virtually all health conditions compared to the hypothetical UK value set. In extension, health-related quality of life enhancing interventions are likely to be given higher priority in decision-making situations where hypothetical values are used to construct quality-adjusted life year-weights. In situations where experience-based quality-adjusted life year-weights are used, life-prolonging interventions would be prioritised.
Department of Medical and Health Sciences, Linkoping University, Sweden mattias.aronsson@liu.se.
Mattias
M
Aronsson
Department of Medical and Health Sciences, Linkoping University, Sweden.
Magnus
M
Husberg
Department of Medical and Health Sciences, Linkoping University, Sweden.
Almina
A
Kalkan
Department of Medical and Health Sciences, Linkoping University, Sweden.
Nathalie
N
Eckard
Department of Medical and Health Sciences, Linkoping University, Sweden.
Jenny
J
Alwin
D006291:Health Policy; D006304:Health Status; D006801:Humans; D011050:Policy Making; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D006113:United Kingdom
EQ-5D; Economic evaluations; quality-adjusted life years