Quality of Life Research

, Volume 25, Issue 11, pp 2693–2710 | Cite as

EQ-5D in Central and Eastern Europe: 2000–2015

  • Fanni Rencz
  • László GulácsiEmail author
  • Michael Drummond
  • Dominik Golicki
  • Valentina Prevolnik Rupel
  • Judit Simon
  • Elly A. Stolk
  • Valentin Brodszky
  • Petra Baji
  • Jakub Závada
  • Guenka Petrova
  • Alexandru Rotar
  • Márta Péntek



Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries.


An electronic database search was performed up to 1 July 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets.


We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n = 11), Bulgaria (n = 6), Czech Republic (n = 18), Hungary (n = 47), Poland (n = 51), Romania (n = 2), Slovakia (n = 3) and Slovenia (n = 14). Cardiovascular (21 %), neurologic (17 %), musculoskeletal (15 %) and endocrine, nutritional and metabolic diseases (13 %) were the most frequently studied clinical areas. Overall, 112 (78 %) of the studies reported EQ VAS results and 86 (60 %) EQ-5D index scores, of which 27 (31 %) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set.


Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened.


EQ-5D Health-related quality of life Value sets Health technology assessment Cost-effectiveness analysis Central and Eastern Europe 


Compliance with Ethical Standards

Conflict of interest

FR, LG, MD, JS, VB, PB, JZ, GP and MP have nothing to disclose. DG reports grants and non-financial support from EuroQol Group, outside the submitted work, and he is a member of the EuroQol Group, a not-for-profit organisation that develops and distributes instruments that assess and value health. VPR is member of the EuroQol Group. EAS is currently employed by EuroQol Research Foundation. In her previous position as academic she has received unrestricted several research grants from EuroQol to conduct EQ-5D related methodological research, outside the submitted work. AR is a salaried employee of Sanofi-Aventis Romania. The review is strictly the personal point of view of the author, and it does not reflect the position of Sanofi-Aventis Romania.

Ethical standard

No ethical approval is required because this is a systematic review.

Informed consent

Informed consent is not required because this is a systematic review


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Fanni Rencz
    • 1
    • 2
  • László Gulácsi
    • 1
    Email author
  • Michael Drummond
    • 3
  • Dominik Golicki
    • 4
  • Valentina Prevolnik Rupel
    • 5
  • Judit Simon
    • 6
  • Elly A. Stolk
    • 7
  • Valentin Brodszky
    • 1
  • Petra Baji
    • 1
  • Jakub Závada
    • 8
  • Guenka Petrova
    • 9
  • Alexandru Rotar
    • 10
  • Márta Péntek
    • 1
  1. 1.Department of Health EconomicsCorvinus University of BudapestBudapestHungary
  2. 2.Semmelweis University Doctoral School of Clinical MedicineBudapestHungary
  3. 3.Centre for Health EconomicsUniversity of YorkHeslingtonUK
  4. 4.Department of Experimental and Clinical PharmacologyMedical University of Warsaw, PolandWarsawPoland
  5. 5.Institute for Economic ResearchLjubljanaSlovenia
  6. 6.Department of Health Economics, Centre for Public HealthMedical University of ViennaViennaAustria
  7. 7.Institute of Health Policy and ManagementErasmus University RotterdamRotterdamThe Netherlands
  8. 8.Institute of Rheumatology1st Faculty of Medicine, Charles UniversityPragueCzech Republic
  9. 9.Department of Social Pharmacy and Pharmacoeconomics, Faculty of PharmacyMedical UniversitySofiaBulgaria
  10. 10.Department of Social MedicineUniversity of AmsterdamAmsterdamThe Netherlands

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