Alternatives to EQ-5D for generating health state utility values report by the Decision Support Unit
These methods should only be used where there are no other data based on validated HRQL measures. Alternative generic preference-based measures and condition-specific preference-based measures of HRQL (CSPBMs) derived from validated measures of HRQL can be used. The scoring should be based on UK gen...
National Institute for Health and Care Excellence (NICE)
2011, March 2011
|Series:||NICE DSU technical support document
|Collection:||National Center for Biotechnology Information - Collection details see MPG.ReNa|
|Summary:||These methods should only be used where there are no other data based on validated HRQL measures. Alternative generic preference-based measures and condition-specific preference-based measures of HRQL (CSPBMs) derived from validated measures of HRQL can be used. The scoring should be based on UK general population values elicited using a choice-based technique, preferably using TTO with the same protocol as the UK EQ-5D valuation. The development of the measure must be fully described including the way health state descriptions are based on validated measures of HRQL and the valuation methods used and their comparability to those used for EQ-5D. Convincing empirical evidence should detail the properties of the alternative measure such as content validity, construct validity, responsiveness and reliability. Evidence should demonstrate the impact on the QALYs gained from using the alternative method to produce HSUVs rather than EQ-5D.|
The NICE Guide to the Methods of Technology Appraisal expresses a preference for using the EQ-5D for adult populations to estimate the Quality Adjusted Life Year (QALY) impact of different technologies. Alternative methods to generating health state utility values (HSUVs) will be considered by NICE in place of EQ-5D when EQ-5D data are either unavailable or inappropriate. Unavailability should be established from a systematic search of the literature. Even if EQ-5D data is unavailable, mapping can be used as an alternative to estimate EQ-5D values rather than the alternative methods described in this Technical Support Guide (see TSD 101). Claims that EQ-5D is inappropriate for measuring the Health Related Quality of Life (HRQL) for a patient group or a specific treatment must be supported by evidence. NICE guidance for alternative methods used to generate HSUVs can be summarised as: 1. Provide supporting argument and evidence for the choice of alternative methods2.
Future research is recommended to examine the use of 'add-on' dimensions to EQ-5D as an alternative to the use of CSPBMs and to the development of a set of measures acceptable to NICE where EQ-5D is not appropriate. Future research is also recommended to examine the comparability and performance of CSPBMs to EQ-5D.
The descriptions of health states being valued should be based on validated patient reported measures of HRQL3. Valuation methods should be comparable to those used to value the EQ-5D4. The impact of using alternative methods on the results of the economic evaluation should be provided and compared to EQ-5D where possible This Technical Support Document (TSD) examines alternative methods to determine the extent to which they are in accordance with the NICE recommendations. Alternative methods to generate HSUVs include other generic preference-based measures, condition-specific preference-based measures of HRQL, health state vignettes, or the direct valuation of own health (such as using the time trade-off (TTO) elicitation technique). Vignettes not based on standardized and validated measures on HRQL and patient own health state valuations do not meet the NICE Methods Guidance and have a limited role.
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