Valuation of the EQ-5D-5L in Taiwan.

Hsiang-Wen Lin,A Simon Pickard,Churn-Shiouh Gau,Chao-Hsiun Tang,Nan Luo,Fang- Ju Lin,Jen-Yu Chang,Chien-Ning Hsu,Juan M Ramos Goñi,Chia-Ing Li,Brecht Devleesschauwer

doi:10.1371/journal.pone.0209344

Abstract

ObjectivesTo date, a value set for the EQ-5D-5L based on the health state preferences of the general Taiwanese population has not been available. This study aimed to develop a Taiwanese value set for EQ-5D-5L to facilitate health technology assessment for medical products and services.MethodsAn international standardized protocol for EQ-5D-5L valuation studies developed by the EuroQol group was adopted. Adult members of the general public were recruited from six geographic regions in Taiwan. In computer-based face-to-face interviews, each participant completed 10 composite time trade-off (C-TTO) tasks and 7 discrete choice experiment (DCE) tasks. The C-TTO and DCE data were modeled alone or in combination (using hybrid models) with additive models containing 20 dummy variables as main effects. The model performance was assessed both quantitatively and qualitatively (mainly logical consistency and prediction patterns).ResultsOf 1,073 recruited participants, 1,000 completed the study. Approximately 13% of observed utility values were -1 in the C-TTO tasks. The hybrid model, using all available data that assumed C-TTO response values left-censored at -1 and with main effects coefficients with logical consistency (monotonicity), was considered as the most appropriate model. The predicted utility ranged from -1.0259 to 1.ConclusionsAn EQ-5D-5L value set was developed for Taiwan using an established study protocol and a representative sample of the general population. This may facilitate health economic evaluations and decision making on resource allocation under Taiwan’s national health insurance program in the future.

Highlights

The National Health Insurance (NHI) program is compulsory for all citizens and employees in Taiwan
An EQ-5D-5L value set was developed for Taiwan using an established study protocol and a representative sample of the general population
To obtain utility for an EQ-5D-5L health state, for instance “12345”, using the final preferred value set, we established the following calculation: Utility weight (“12345”) = 1 –(0)–(0.0757)–[(0.0726)+(0.0508)]– [(0.0868)+(0.0710)+(0.1824)]–[(0.0637)+(0.1192)+(0.1572)+(0.0811)] = 0.0395. Using both composite time trade-off (C-TTO) and discrete choice experiment (DCE) data derived from a sample representative of the Taiwanese adult general population, we identified the most appropriate value set of EQ-5D-5L for Taiwan

Summary

Introduction

The National Health Insurance (NHI) program is compulsory for all citizens and employees in Taiwan. Cost-effectiveness analysis of new medications, medical devices and interventions in the Center for Drug Evaluation is encouraged under the policy of National Health Insurance Administration in Taiwan [3]. The official guidelines for cost-effectiveness analysis and budget impact analysis, published by the Center for Drug Evaluation, have recommended using health utility measures in order to facilitate cost-effectiveness analysis [3], in which the EuroQol five-dimensional (EQ-5D) measure was listed as one of the recommended instruments. The EQ-5D-3L is listed as one of five main outcome measures in the “Quality Enhancement Pilot Project”, sponsored by the National Health Insurance Administration [6]. Numerous countries have published EQ-5D-5Lvalue sets using the standardized protocol [10,11,12,13,14,15,16,17], with more forthcoming

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