Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines Manila, Manila, Philippines.
Institute for Public Health and Management, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Qual Life Res. 2022 Sep;31(9):2763-2774. doi: 10.1007/s11136-022-03143-w. Epub 2022 May 9.
The Philippines has recommended the use of Quality-Adjusted Life Years (QALYs) in government health technology assessments (HTA). We aimed to develop a value set for the EQ-5D-5L based on health preferences of the healthy general adult population in the Philippines.
Healthy, literate adults were recruited from the Philippine general population with quota targets based on age, sex, administrative region, type of residence, education, income, and ethnolinguistic groups. Each participant's preference was elicited by completing Composite Time Trade-Off (C-TTO) and Discrete Choice Experiment (DCE) tasks. Tasks were computer-assisted using the EuroQol Valuation Technology 2.0. To estimate the value set, we explored 20- and 8-parameter models that either use c-TTO-only data or both c-TTO and DCE (also called hybrid models). Final model choice was guided by principles of monotonicity, out-of-sample likelihood, model fit, and parsimony.
We recruited 1000 respondents with demographic characteristics that approximate the general population such as 49.6% Female, 82% Roman Catholic, 40% in urban areas, and 55% finished high school. None of the 20-parameter models demonstrated monotonicity (logical worsening of coefficients with increasing severity). From the 8-parameter models, the homoscedastic TTO-only model exhibited the best fit. From this model, mobility and pain/ discomfort had the highest effect on utilities.
The selected model for representing the Philippine general population preferences for EQ-5D-5L health states was an 8-parameter homoscedastic TTO-only model. This value set is recommended for use in QALY calculations in support of HTA-informed coverage decisions in the Philippines.
菲律宾建议在政府卫生技术评估（HTA）中使用质量调整生命年（QALYs）。我们旨在根据菲律宾健康普通成年人群的健康偏好，制定基于 EQ-5D-5L 的价值体系。
从菲律宾普通人群中按年龄、性别、行政区域、居住类型、教育、收入和民族语言群体的配额目标招募健康、有文化的成年人。通过完成综合时间权衡（C-TTO）和离散选择实验（DCE）任务来得出每个参与者的偏好。任务使用 EuroQol 估值技术 2.0 进行计算机辅助。为了估计价值体系，我们探索了使用仅 C-TTO 数据或 C-TTO 和 DCE（也称为混合模型）的 20 个和 8 个参数模型。最终模型选择的指导原则是单调性、样本外似然性、模型拟合和简约性。
我们招募了 1000 名具有人口统计学特征的受访者，这些特征与普通人群相似，例如 49.6%为女性、82%为罗马天主教徒、40%居住在城市地区，55%完成了高中学业。没有一个 20 个参数模型表现出单调性（随着严重程度的增加，系数逻辑恶化）。在 8 个参数模型中，同方差 TTO 模型表现出最佳拟合。在这个模型中，移动性和疼痛/不适对效用的影响最大。
代表菲律宾普通人群对 EQ-5D-5L 健康状况偏好的选定模型是一个 8 个参数的同方差 TTO 模型。建议在 QALY 计算中使用该价值体系，以支持菲律宾基于 HTA 的覆盖决策。
