Top

Health and Quality of Life Outcomes

Published in:

Open Access 01-12-2015 | Research

Does the choice of EQ-5D tariff matter? A comparison of the Swedish EQ-5D-3L index score with UK, US, Germany and Denmark among type 2 diabetes patients

Authors: Aliasghar A. Kiadaliri, Björn Eliasson, Ulf-G Gerdtham

Published in: Health and Quality of Life Outcomes | Issue 1/2015

Abstract

Objective

To compare the performance of the recently developed Swedish experience-based time trade-off (TTO) valuation of the EuroQol-5D-3L (EQ-5D-3L) against the hypothetical-based TTO valuations from UK, US, Germany and Denmark.

Methods

Type 2 diabetes patients from the Swedish National Diabetes Register (N = 1 757) responded to EQ-5D-3L questionnaire in 2008. Health utilities were compared using a range of parametric and nonparametric tests. Absolute agreement and consistency were investigated using intra-class correlations coefficients (ICCs) and Bland-Altman plots. Differences in health utilities between known-groups were evaluated. Transition scores for pairs of observed EQ-5D-3L health states were calculated and compared.

Results

The Swedish tariff (SWT) resulted in substantially higher health utilities and differences were more profound for more severe health problems. ICC ranged 0.6 to 0.8 and Bland-Altman plots showed wide limits of agreement. While all tariffs discriminate between known-groups, the effect sizes were generally small. The SWT had higher (lower) known-group validity for macrovascular (microvascular) complications. The SWT and UK tariff were associated with the lowest and the highest mean absolute transition scores, respectively, for 2775 observed pairs of the EQ-5D-3L health states.

Conclusion

There were systematic differences between the SWT and tariffs from other countries meaning that the choice of tariff might have substantial impact on funding decisions. The Swedish experienced-based TTO valuation will give higher priority to life-extending interventions than those which improve quality of life. We suggest that economic evaluations in Sweden include both Swedish experience-based and non-Swedish hypothetical-based valuations through a sensitivity analysis.

Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J, et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(3):293–301. doi:10.1016/j.diabres.2010.01.026.CrossRefPubMed

Janssen MF, Lubetkin EI, Sekhobo JP, Pickard AS. The use of the EQ-5D preference-based health status measure in adults with Type 2 diabetes mellitus. Diabet Med. 2011;28(4):395–413. doi:10.1111/j.1464-5491.2010.03136.x.CrossRefPubMed

Kiadaliri AA, Najafi B, Mirmalek-Sani M. Quality of life in people with diabetes: a systematic review of studies in Iran. J Diabetes Metab Disord. 2013;12(1):54. doi:10.1186/2251-6581-12-54.PubMedCentralCrossRefPubMed

Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53–72.CrossRefPubMed

Mulhern B, Meadows K. The construct validity and responsiveness of the EQ-5D, SF-6D and Diabetes Health Profile-18 in type 2 diabetes. Health Qual Life Outcomes. 2014;12:42. doi:10.1186/1477-7525-12-42.PubMedCentralCrossRefPubMed

Peeters Y, Stiggelbout AM. Health state valuations of patients and the general public analytically compared: a meta-analytical comparison of patient and population health state utilities. Value Health. 2010;13(2):306–9. doi:10.1111/j.1524-4733.2009.00610.x.CrossRefPubMed

Polsky D, Willke RJ, Scott K, Schulman KA, Glick HA. A comparison of scoring weights for the EuroQol derived from patients and the general public. Health Econ. 2001;10(1):27–37.CrossRefPubMed

Hadorn DC. The role of public values in setting health care priorities. Soc Sci Med. 1991;32(7):773–81.CrossRefPubMed

Brazier J, Akehurst R, Brennan A, Dolan P, Claxton K, McCabe C, et al. Should patients have a greater role in valuing health states? Appl Health Econ Health Policy. 2005;4(4):201–8.CrossRefPubMed

10.

Ubel PA, Loewenstein G, Jepson C. Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Qual Life Res. 2003;12(6):599–607.CrossRefPubMed

11.

Burstrom K, Sun S, Gerdtham UG, Henriksson M, Johannesson M, Levin LA, et al. Swedish experience-based value sets for EQ-5D health states. Qual Life Res. 2014;23(2):431–42. doi:10.1007/s11136-013-0496-4.PubMedCentralCrossRefPubMed

12.

Dolan P. Modeling valuations for EuroQol health states. Med Care. 1997;35(11):1095–108.CrossRefPubMed

13.

De Wit GA, Busschbach JJ, De Charro FT. Sensitivity and perspective in the valuation of health status: whose values count? Health Econ. 2000;9(2):109–26.CrossRefPubMed

14.

Little MH, Reitmeir P, Peters A, Leidl R. The impact of differences between patient and general population EQ-5D-3L values on the mean tariff scores of different patient groups. Value Health. 2014;17(4):364–71. doi:10.1016/j.jval.2014.02.002.CrossRefPubMed

15.

Nemes S, Burstrom K, Zethraeus N, Eneqvist T, Garellick G, Rolfson O. Assessment of the Swedish EQ-5D experience-based value sets in a total hip replacement population. Qual Life Res. 2015. doi:10.1007/s11136-015-1020-9.

16.

Kiadaliri AA, Gerdtham UG, Eliasson B, Gudbjornsdottir S, Svensson AM, Carlsson KS. Health utilities of type 2 diabetes-related complications: a cross-sectional study in Sweden. Int J Environ Res Public Health. 2014;11(5):4939–52. doi:10.3390/ijerph110504939.PubMedCentralCrossRefPubMed

17.

Shaw JW, Johnson JA, Coons SJ. US valuation of the EQ-5D health states: development and testing of the D1 valuation model. Med Care. 2005;43(3):203–20.CrossRefPubMed

18.

Wittrup-Jensen KU, Lauridsen J, Gudex C, Pedersen KM. Generation of a Danish TTO value set for EQ-5D health states. Scand J Public Health. 2009;37(5):459–66. doi:10.1177/1403494809105287.CrossRefPubMed

19.

Greiner W, Claes C, Busschbach JJ, von der Schulenburg JM. Validating the EQ-5D with time trade off for the German population. Eur J Health Econ. 2005;6(2):124–30.CrossRefPubMed

20.

Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005;14(6):1523–32.CrossRefPubMed

21.

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.CrossRefPubMed

22.

Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.CrossRefPubMed

23.

Cicchetti D. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1994;6(4):284–90.CrossRef

24.

Cuzick J. A Wilcoxon-type test for trend. Stat Med. 1985;4(1):87–90.CrossRefPubMed

25.

Nan L, Johnson JA, Shaw JW, Coons SJ. A comparison of EQ-5D index scores derived from the US and UK population-based scoring functions. Med Decis Making. 2007;27(3):321–6. doi:10.1177/0272989X07300603.CrossRef

26.

Cohen J. Statistical power analysis for the behavioral sciences. USA: Hillsdale. Lawrence Earlbaum Associates: NJ; 1988.

27.

Feeny D. The multi-attribute utility approach to assessing health-related quality of life. In: Jones AM, editor. The Elgar Companion to Health Economics. UK: Edward Elgar Publishing Limited; 2006.

28.

Whitehurst DG, Bryan S. Another study showing that two preference-based measures of health-related quality of life (EQ-5D and SF-6D) are not interchangeable. But why should we expect them to be? Value Health. 2011;14(4):531–8. doi:10.1016/j.jval.2010.09.002.CrossRefPubMed

29.

Arnold D, Girling A, Stevens A, Lilford R. Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis. BMJ. 2009;339:b2688. doi:10.1136/bmj.b2688.PubMedCentralCrossRefPubMed

30.

Burstrom K, Johannesson M, Diderichsen F. A comparison of individual and social time trade-off values for health states in the general population. Health Policy. 2006;76(3):359–70. doi:10.1016/j.healthpol.2005.06.011.CrossRefPubMed

31.

Zethraeus N, Johannesson M. A comparison of patient and social tariff values derived from the time trade-off method. Health Econ. 1999;8(6):541–5.CrossRefPubMed

32.

Oremus M, Tarride JE, Clayton N. Canadian Willingness-to-Pay Study G, Raina P. Health utility scores in Alzheimer’s disease: differences based on calculation with American and Canadian preference weights. Value Health. 2014;17(1):77–83. doi:10.1016/j.jval.2013.10.009.CrossRefPubMed

Title: Does the choice of EQ-5D tariff matter? A comparison of the Swedish EQ-5D-3L index score with UK, US, Germany and Denmark among type 2 diabetes patients
Authors: Aliasghar A. Kiadaliri
Björn Eliasson
Ulf-G Gerdtham
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-015-0344-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does the choice of EQ-5D tariff matter? A comparison of the Swedish EQ-5D-3L index score with UK, US, Germany and Denmark among type 2 diabetes patients

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

Relationship between optimism and quality of life in patients with two chronic rheumatic diseases: axial spondyloarthritis and chronic low back pain: a cross sectional study of 288 patients

Detecting short-term change and variation in health-related quality of life: within- and between-person factor structure of the SF-36 health survey

The use of Subject Matter Experts in Validating an Oral Health-Related Quality of Life measure in Korean

Development and validation of the BRIGHTLIGHT Survey, a patient-reported experience measure for young people with cancer

Self-rated health supersedes patient satisfaction with service quality as a predictor of survival in prostate cancer

Psychometric properties of the incontinence utility index among patients with idiopathic overactive bladder: data from two multicenter, double-blind, randomized, Phase 3, placebo-controlled clinical trials