Ben Ângela, Finch Aureliano Paolo, van Dongen Johanna M, de Wit Maartje, van Dijk Susan E M, Snoek Frank J, Adriaanse Marcel C, van Tulder Maurits W, Bosmans Judith E
Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Medical Psychology, Amsterdam University Medical Centers - VUmc, Amsterdam, The Netherlands.
Health Econ. 2020 May;29(5):640-651. doi: 10.1002/hec.4008. Epub 2020 Feb 14.
This study compares the five-level EuroQol five-dimension questionnaire (EQ-5D-5L) crosswalks and the 5L value sets for England, the Netherlands, and Spain and explores the implication of using one or the other for the results of cost-utility analyses. Data from two randomized controlled trials in depression and diabetes were used. Utility value distributions were compared, and mean differences in utility values between the EQ-5D-5L crosswalk and the 5L value set were described by country. Quality-adjusted life years (QALYs) were calculated using the area-under-the-curve method. Incremental cost-effectiveness ratios (ICERs) were calculated, and uncertainty around ICERs was estimated using bootstrapping and graphically shown in cost-effectiveness acceptability curves. For all countries investigated, utility value distributions differed between the EQ-5D-5L crosswalk and 5L value set. In both case studies, mean utility values were lower for the EQ-5D-5L crosswalk compared with the 5L value set in England and Spain, but higher in the Netherlands. However, these differences in utility values did not translate into relevant differences across utility estimation methods in incremental QALYs and the interventions' probability of cost-effectiveness. Thus, our results suggest that EQ-5D-5L crosswalks and 5L value sets can be used interchangeably in patients affected by mild or moderate conditions. Further research is needed to establish whether these findings are generalizable to economic evaluations among severely ill patients.
本研究比较了英国、荷兰和西班牙的五级欧洲五维度健康量表问卷（EQ-5D-5L）转换表及5L值集，并探讨了在成本效用分析结果中使用其中一种或另一种的意义。使用了来自两项抑郁症和糖尿病随机对照试验的数据。比较了效用值分布，并按国家描述了EQ-5D-5L转换表与5L值集之间效用值的平均差异。使用曲线下面积法计算质量调整生命年（QALY）。计算增量成本效益比（ICER），并使用自举法估计ICER周围的不确定性，并在成本效益可接受性曲线中以图形方式显示。对于所有调查的国家，EQ-5D-5L转换表与5L值集之间的效用值分布存在差异。在两个案例研究中，与英国和西班牙的5L值集相比，EQ-5D-5L转换表的平均效用值较低，但在荷兰则较高。然而，这些效用值差异并未转化为增量QALY中效用估计方法之间的相关差异以及干预措施的成本效益概率。因此，我们的结果表明，EQ-5D-5L转换表和5L值集在轻度或中度疾病患者中可以互换使用。需要进一步研究以确定这些发现是否可推广到重症患者的经济评估中。
