PharmacoEconomics

, Volume 32, Issue 6, pp 591–599 | Cite as

Using the EuroQol EQ-5D in Swiss Cancer Patients, Which Value Set Should be Applied?

  • Klazien Matter-Walstra
  • Dirk Klingbiel
  • Thomas Szucs
  • Bernhard C. Pestalozzi
  • Matthias Schwenkglenks
Original Research Article

Abstract

Background

The European Quality of Life–5 Dimensions (EQ-5D) instrument combines questionnaire responses into a single utility estimate using country-specific value sets. Countries without a national value set are advised to select one based on geographic proximity. In the absence of a Swiss value set, we used foreign value sets to gain insights into their appropriateness for use with Swiss cancer patients.

Methods

EQ-5D health states and visual analogue scale (VAS) ratings were collected in one German and three Swiss oncology trials. Utilities were calculated based on the United Kingdom (UK), German (GE), French (FR) and European Union (EU) value sets. Resulting differences and Pearson partial correlation coefficients with corresponding VAS ratings were assessed.

Results

In total, 202 Swiss and 154 German patients undergoing cancer treatment completed at least two EQ-5D forms. The mean difference between GE-based and FR-, UK- or EU-based utilities was significantly larger than the differences between the latter. The absolute mean difference between utilities and VAS ratings was highest for GE-based utilities, for Swiss (0.170, 95 % confidence interval [CI] 0.146–0.194) and German patients (0.174, 95 % CI 0.145–0.202). The correlation between GE-based utilities and VAS ratings was the lowest (r = 0.36, 95 % CI 0.33–0.40); the highest was between FR-based utilities and VAS ratings (r = 0.43, 95 % CI 0.39–0.46).

Conclusion

For Switzerland, utility calculations based on the German or French value set would be an obvious choice. Our results suggest that the German value set may not be the most appropriate for use with Swiss cancer patients. The French and EU value sets may be relevant alternatives and improve international comparability.

Notes

Acknowledgments

The authors would like to thank the principal investigators Prof. Dr. med Christoph Rochlitz (SAKK 24/09), Prof. Dr. med Thomas Ruhstaller (SAKK 75/08), Prof. Dr. med Jean-François Dufour (SAKK 77/09) and Dr. med Markus Jörger (CEPAC-TDM) for providing the EQ-5D data for this study.

Source of financial support

This study was funded by the Swiss State Secretariat for Education, Research and Innovation. The Health economic sub-project of the SAKK Trial 75/08 was funded by a grant from the Swiss Cancer Research Foundation.

Conflict of interest

The authors declare no conflicts of interest.

Authors’ contribution

Klazien Matter-Walstra was the main person responsible for planning and conducting the study, performing statistical analyses and writing the manuscript.

Dirk Klingbiel gave statistical support and reviewed the manuscript.

Matthias Schwenkglenks contributed to the planning of the study and interpretation of results, and reviewed the manuscript.

Thomas Szucs, Bernhard Pestalozzi gave support on content and reviewed the manuscript.

Supplementary material

40273_2014_151_MOESM1_ESM.docx (48 kb)
Supplementary material 1 (DOCX 47 kb)

References

  1. 1.
    Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337–43.PubMedCrossRefGoogle Scholar
  2. 2.
    Bailey H, Kind P. Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets. Qual Life Res. 2010;19(8):1145–54.PubMedCrossRefGoogle Scholar
  3. 3.
    Norman R, Cronin P, Viney R, King M, Street D, Ratcliffe J. International comparisons in valuing EQ-5D health states: a review and analysis. Value Health. 2009;12(8):1194–200.PubMedCrossRefGoogle Scholar
  4. 4.
    Bernert S, Fernandez A, Haro JM, Konig HH, Alonso J, Vilagut G, et al. Comparison of different valuation methods for population health status measured by the EQ-5D in three European countries. Value Health. 2009;12(5):750–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Heijink R, van Baal P, Oppe M, Koolman X, Westert G. Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets. Popul Health Metrics. 2011;9(1):17.CrossRefGoogle Scholar
  6. 6.
    Kharroubi SA, O’Hagan A, Brazier JE. A comparison of United States and United Kingdom EQ-5D health states valuations using a nonparametric Bayesian method. Stat Med. 2010;29(15):1622–34.PubMedGoogle Scholar
  7. 7.
    Knies S, Evers SM, Candel MJ, Severens JL, Ament AJ. Utilities of the EQ-5D: transferable or not? Pharmacoeconomics. 2009;27(9):767–79.PubMedCrossRefGoogle Scholar
  8. 8.
    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.CrossRefGoogle Scholar
  9. 9.
    Oppong R, Kaambwa B, Nuttall J, Hood K, Smith RD, Coast J. The impact of using different tariffs to value EQ-5D health state descriptions: an example from a study of acute cough/lower respiratory tract infections in seven countries. Eur J Health Econ. 2013;14:197–209.PubMedCrossRefGoogle Scholar
  10. 10.
    Szende A, Oppe M, Devlin N. EQ-5D value sets, inventory, comparative review and user guide. The Netherlands: Springer; 2007.CrossRefGoogle Scholar
  11. 11.
    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.PubMedCrossRefGoogle Scholar
  12. 12.
    Chevalier J, de Pouvourville G. Valuing EQ-5D using Time Trade-Off in France. Eur J Health Econ. 2013;14(1):57–66.PubMedCrossRefGoogle Scholar
  13. 13.
    Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J, et al. A single European currency for EQ-5D health states. Results from a six-country study. Eur J Health Econ. 2003;4(3):222–31.PubMedCrossRefGoogle Scholar
  14. 14.
    Drummond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddart GL, editors. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press; 2005. p. 143–7.Google Scholar
  15. 15.
    Whynes DK. Correspondence between EQ-5D health state classifications and EQ VAS scores. Health Qual Life Outcomes. 2008;6:94.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Gunther OH, Roick C, Angermeyer MC, Konig HH. The responsiveness of EQ-5D utility scores in patients with depression: a comparison with instruments measuring quality of life, psychopathology and social functioning. J Affect Disord. 2008;105(1–3):81–91.PubMedCrossRefGoogle Scholar
  17. 17.
    Stark RG, Reitmeir P, Leidl R, Konig HH. Validity, reliability, and responsiveness of the EQ-5D in inflammatory bowel disease in Germany. Inflamm Bowel Dis. 2010;16(1):42–51.PubMedCrossRefGoogle Scholar
  18. 18.
    Badia X, Herdman M, Roset Dipstat M, Ohinmaa A. Feasibility and validity of the VAS and TTO for eliciting general population values for temporary health states: a comparative study. Health Serv Outcomes Res Methodol. 2001;2:51–65.Google Scholar
  19. 19.
    Pickard AS, Neary MP, Cella D. Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer. Health Qual Life Outcomes. 2007;5:70.Google Scholar
  20. 20.
    Rutten-van Molken MP, Oostenbrink JB, Tashkin DP, Burkhart D, Monz BU. Does quality of life of COPD patients as measured by the generic EuroQol five-dimension questionnaire differentiate between COPD severity stages? Chest. 2006;130(4):1117–28.PubMedCrossRefGoogle Scholar
  21. 21.
    Whynes DK. Does the correspondence between EQ-5D health state description and VAS score vary by medical condition? Health Qual Life Outcomes. 2013;11(1):155.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Perneger TV, Combescure C, Courvoisier DS. General population reference values for the French version of the EuroQol EQ-5D health utility instrument. Value Health. 2010;13(5):631–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Klazien Matter-Walstra
    • 1
    • 2
  • Dirk Klingbiel
    • 2
  • Thomas Szucs
    • 1
  • Bernhard C. Pestalozzi
    • 3
  • Matthias Schwenkglenks
    • 1
  1. 1.Institute of Pharmaceutical Medicine/ECPMUniversity of BaselBaselSwitzerland
  2. 2.Swiss Group for Clinical Cancer Research Coordinating CenterBernSwitzerland
  3. 3.Department of Medical OncologyUniversity HospitalZurichSwitzerland

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