Abstract
In health economic evaluations the quality-adjusted life-year (QALY) is one of the preferred outcome measures. Catalogues of median-based decrements in EQ-5D-3L index scores for chronic conditions exist to inform economic evaluations but may not be appropriate for this purpose as mean, rather than median, EQ-5D-3L index scores are of primary interest. Firstly, we aim to estimate mean decrements in EQ-5D-3L index scores through a simple stratified analysis as an alternative to regression modelling. In addition, we aim to estimate the mean decrement in EQ-5D-3L index scores in percent relative to a disease-free reference population. Secondly, we aim to handle both multiple imputation and appropriate estimation of standard errors in the presence of individual sampling weights. Data on EQ-5D-3L from the National Health Profile, Denmark, 2013, were used to estimate the EQ-5D-3L index scores. Calculation of decrements in EQ-5D-3L index scores of chronic conditions was done while controlling for the additional number of chronic conditions beside the one in question, age and sex. Also, a test of homogeneity of decrements across subgroups was conducted. We provide a mini-catalogue of new percentage-scale decrements in EQ-5D-3L index scores. For example, we estimated that angina was associated with an 8.2% reduction in the EQ-5D-3L index score compared to a reference group without angina. If the mean EQ-5D-3L score was 0.848 among corresponding groups without angina; angina patients would have an EQ-5D-3L index score of (1-0.082)·0.848=0.778 using the percentage-scale. The estimated percentage reduction in the EQ-5D-3L index score was homogenous regardless of the number of additional chronic conditions, age and sex. We suggest a percentage-scale estimation of EQ-5D-3L index scores for chronic disorders as an alternative to existing median-based methods. Our estimates stem from a simpler model, which, we argue, is easier to use and interpret.Published: Online May 2016. In print August 2016.
Highlights
In health economic evaluations the quality-adjusted life-year (QALY) is one of the preferred outcome measures
As EQ-5D-3L index scores are not always readily available, catalogues have been developed with utility scores for chronic conditions, thereby making it possible to estimate the loss in health-related quality of life associated with a specific disease of interest (Sullivan and Ghushchyan, 2006; Sullivan et al, 2005; Sullivan et al, 2011)
We aimed to investigate the impact of sex, age and the number of additional chronic conditions beside the one in question on mean decrements
Summary
In health economic evaluations the quality-adjusted life-year (QALY) is one of the preferred outcome measures. The QALY incorporates both quantity and quality of life, thereby allowing for comparison across different diseases, including chronic conditions (Brazier et al, 2007). The EQ-5D-3L is a generic health-related quality of life instrument that has been used to describe population health and health outcomes in clinical trials and health economic evaluations. As EQ-5D-3L index scores are not always readily available, catalogues have been developed with utility scores for chronic conditions, thereby making it possible to estimate the loss in health-related quality of life associated with a specific disease of interest (Sullivan and Ghushchyan, 2006; Sullivan et al, 2005; Sullivan et al, 2011)
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