A Feasible Estimation of a “Corrected” EQ-5D Social Tariff

• Published in: Value in health Vol. 27; no. 9; pp. 1243 - 1250
• Main Authors: Abellan-Perpiñan, Jose-Maria, Martinez-Perez, Jorge-Eduardo, Sanchez-Martinez, Fernando-Ignacio, Pinto-Prades, Jose-Luis
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2024
• Subjects: Adult; Aged; corrective approach; debiasing; EQ-5D; Feasibility Studies; Female; Health Status; health-state utilities; Humans; Male; Middle Aged; Quality of Life; Quality-Adjusted Life Years; social tariffs; Spain; Surveys and Questionnaires; Young Adult; Spain; EQ-5D; corrective approach; debiasing; social tariffs; health-state utilities
• ISSN: 1098-3015; 1524-4733; 1524-4733
• DOI: 10.1016/j.jval.2024.05.004

To demonstrate the feasibility of estimating a social tariff free of utility curvature and probability weighting biases and to test transferability between riskless and risky contexts.
Valuations for a selection of EQ-5D-3L health states were collected from a large and representative sample (N = 1676) of the Spanish general population through computer-assisted personal interviewing. Two elicitation methods were used: the traditional time trade-off (TTO) and a novel risky-TTO procedure. Both methods are equivalent for better than death states, which allowed us to test transferability of utilities across riskless and risky contexts. Corrective procedures applied are based on rank-dependent utility theory, identifying parameter estimates at the individual level. All corrections are health-state specific, which is a unique feature of our corrective approach.
Two corrected value sets for the EQ-5D-3L system are estimated, highlighting the feasibility of developing national tariffs under nonexpected utility theories, such as rank-dependent utility. Furthermore, transferability was not supported for at least half of the health states valued by our sample.
It is feasible to estimate a social tariff by using interviewing techniques, sample sizes, and sample representativeness equivalent to prior studies designed to generate national value sets for the EQ-5D. Utilities obtained in distinct contexts may not be interchangeable. Our findings caution against routinely taking transferability of utility for granted.
•To date there is no national social tariff or value set fully corrected under nonexpected utility assumptions.•This article presents 2 value sets for the EQ-5D-3L system estimated by applying corrections based on rank-dependent utility theory, identifying parameter estimates at individual level. All corrections done are health-state specific, which is a unique feature of our corrective approach. These findings highlight the feasibility of developing national tariffs under nonexpected utility theories.•Our results suggest that utilities obtained in distinct contexts may not be interchangeable. Transferability across riskless and risky domains was not supported for at least half of the health states valued by our sample. Consequently, it seems that ensuring tariffs are not context dependent is as relevant and challenging as correcting value sets.