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Econometric modelling of multiple self-reports of health states: The switch from EQ-5D-3L to EQ-5D-5L in evaluating drug therapies for rheumatoid arthritis()

EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5...

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Detalles Bibliográficos
Autores principales: Hernández-Alava, Mónica, Pudney, Stephen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier North Holland 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597047/
https://www.ncbi.nlm.nih.gov/pubmed/28778350
http://dx.doi.org/10.1016/j.jhealeco.2017.06.013
Descripción
Sumario:EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but the consequences of this change are uncertain. We develop a multi-equation ordinal response model incorporating a copula specification with normal mixture marginals to analyse joint responses to EQ-5D-3L and EQ-5D-5L in a survey of people with rheumatic disease, and use it to generate mappings between the alternative descriptive systems. We revisit a major cost-effectiveness study of drug therapies for rheumatoid arthritis, mapping the original EQ-5D-3L measure onto a 5L valuation basis. Working within a comprehensive, flexible econometric framework, we find that use of simpler restricted specifications can make very large changes to cost-effectiveness estimates with serious implications for decision-making.