Questioning the differences between general public vs. patient based preferences towards EQ-5D-5L defined hypothetical health states

Abstract

The purpose of this article is to explore whether any differences exist between the general population and patient based preferences towards EQ-5D-5L defined hypothetical health states. The article discusses the role of adaptation and self-interest in valuing health states and it also contributes rigorous empirical evidence to the scientific debate on the differences between the patient and general population preferences towards hypothetical health states. Patient preferences were elicited in 2015 with the EQ-5D-5L questionnaire using time trade-off and discrete choice experiment design and compared to the Spanish general population preferences, which were elicited using identical methods. Patients were chosen on a voluntary basis according to their willingness to participate in the survey. They were recruited from patient organisations and a hospital in Madrid, Spain. 282 metastatic breast cancer patients and 333 rheumatoid arthritis patients were included in the sample. The analysis revealed differences in preferences between the general population and patient groups. Based on the results of our analysis, it is suggested that the differences in preferences stem from patients being more able to accurately imagine “non-tangible” dimensions of health states (anxiety or depression, and pain or discomfort) than the general population with less experience in various health states. However, this does not mean that general public values should not be reflected in utilities derived for coverage decision making.