An Australian Value Set for the EQ-5D-Y-3L.

backgroundAustralia has a well-established health technology assessment process and there is extensive use of generic health related quality of life (HRQoL) instruments in evidence presented to it. However, there are gaps in tools and evidence available to support evaluation of paediatric health. The aim of this paper is to produce an Australian EQ-5D-Y-3L (Y-3L) value set.

methodsThe methods follow the international Y-3L valuation protocol, but with an expanded design. Data were collected using Composite Time Trade Off (cTTO) and Discrete Choice Experiment (DCE) data from two independent samples of adult members of the Australian general public. In total, 52 Y-3L health states, assigned into four blocks of 14 health states each containing health state 33333, were valued using cTTO. cTTO data were collected via videoconferencing interview and each respondent valued 14 health states. Mean observed cTTO values were adjusted for censoring at -1 using a Tobit model. For the DCE component, 150 latent scale DCE choice pairs were collected via an online survey with each participant completing 15 pairs. DCE data were modelled using a garbage class mixed logit model. Two approaches to anchor DCE data to the Quality Adjusted Life Years (QALYs) scale were explored: anchoring on the value for the worst health state (33333); and mapping DCE data onto the mean cTTO values using all 52 health states. Two evaluation criteria were used to select the final value set: (1) coefficient significance and logical consistency; (2) prediction accuracy of the mean observed cTTO values.

resultsIn total, 268 individuals participated in the cTTO interviews, and 1002 completed the DCE. The linear mapping without intercept performed best and was selected as the final value set. Health state values ranged between 0.142 and 1. The relative importance of domains by level 3 coefficients (ordered from most to least important) was: pain/discomfort, then feeling worried, sad or unhappy, usual activities, looking after myself, and mobility.

conclusionThis study reports an Australian value set for the Y-3L, which enables the calculation of QALYs for use in the economic evaluation of paediatric interventions and can support evidence development and decision making.