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Health-related quality of life measured with the EQ-5D-5L: estimation of normative index values based on a representative German population sample and value set

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The generic and preference-based instrument EQ-5D is available in a five-response levels version (EQ-5D-5L). A value set for the EQ-5D-5L based on a representative sample of the German population has recently been developed. The aim of this study was to estimate normative values of the EQ-5D-5L index for Germany, and to examine associations between the EQ-5D-5L and selected sociodemographic factors.


The analysis was based on a representative sample (n = 4998) of the German general adult population in 2014. Participants had to rate their health-related quality of life on the EQ-5D-5L descriptive system as well as on a visual analogue scale (EQ-VAS). Normative values of the EQ-5D-5L index were estimated for selected sociodemographic characteristics. For the examination of associations between EQ-5D-5L index scores and selected sociodemographic factors, multivariate regression analyses were used.


The mean EQ-5D-5L index score of the total sample was 0.88 (SD 0.18), corresponding to an overall mean EQ-VAS score of 71.59 (SD 21.36). Female gender and increasing age were associated with a lower EQ-5D-5L index score (p < 0.001). Higher education, full-time employment and private health insurance were associated with a higher EQ-5D-5L index score (p < 0.001).


This was the first study to estimate normative values of the EQ-5D-5L index for Germany based on a representative sample. The German normative values of the EQ-5D-5L are comparable to those reported for other countries. However, the mean EQ-5D-5L index score of the total sample was worse than those of the samples of studies from other countries.

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We thank Maria Meyer for her support in visualization and data presentation as well as two anonymous referees for their helpful comments.


This study was funded by the German Federal Ministry of Education and Research (BMBF; Grant number: 01EH1101B).

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Correspondence to Thomas Grochtdreis.

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Appendix 1

See Table 5.

Table 5 Frequencies of item responses in each EQ-5D-5L dimension by age category in percent (%; weighted sample)

Appendix 2

See Table 6.

Table 6 Mean EQ-5D-5L index scores by age categories by number of medical conditions (weighted sample)

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Grochtdreis, T., Dams, J., König, HH. et al. Health-related quality of life measured with the EQ-5D-5L: estimation of normative index values based on a representative German population sample and value set. Eur J Health Econ 20, 933–944 (2019).

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