What matters most? Evidence-based findings of health dimensions affecting the societal preferences for EQ-5D health states.

Monica Viegas Andrade,Ana Carolina Maia,Kenya Valeria Micaela De Souza Noronha,Paul Kind

doi:10.1590/0102-311x00021113

Abstract

This study analyzes how different health dimensions defined by the EQ-5D-3L instrument affect average individual preferences for health states. This analysis is an important benchmark for the incorporation of health technologies as it takes into consideration Brazilian population preferences in health resource allocation decisions. The EQ-5D instrument defines health in terms of five dimensions (mobility, daily activities, self-care activities, pain/discomfort, and anxiety/depression) each divided into three levels of severity. Data came from a valuation study with 3,362 literate individuals aged between 18 and 64 living in urban areas of Minas Gerais State, Brazil. The main results reveal that health utility decreases as the level of severity increases. With regard to health issues, mobility stands out as the most important EQ-5D dimension. Independently of severity levels of the other EQ-5D-3L dimensions, the highest decrements in utilities are associated with severe mobility problems.

Highlights

The main purpose of the health technology assessment (HTA) is to assist health policymakers in implementing more cost-effective technologies in order to allocate resources efficiently
The aim of this paper is to evaluate the effect of different EuroQol-5 Dimensions (EQ-5D) health dimensions on individual health states valuation in Brazil
As Brazilian society is still marked by high socioeconomic heterogeneity and low education levels, time trade-off (TTO) may have a better performance in evaluating health preferences

Summary

Introduction

The main purpose of the health technology assessment (HTA) is to assist health policymakers in implementing more cost-effective technologies in order to allocate resources efficiently. At the macro-level, HTA assists policymakers in formulating public health policies while at the micro-level it is mainly used to support the development of clinical practice guidelines and to assist physicians in efficiently combining individual technologies 1,2. Even though new health technologies contribute to improve population health, their uncritical use increases health expenditures and may have strong budget impacts. This impact can threaten the access to health care services especially among low income groups 3,4,5,6,7,8. The incorporation process of technologies in the healthcare sector presents peculiar characteristics. It is quite dynamic and in general is supplier-induced demand. The more care they get the better 9,10

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Results