Estimating the EQ-5D-5L value set for the Philippines

• Published in: Quality of life research Vol. 31; no. 9; pp. 2763 - 2774
• Main Authors: Miguel, Red Thaddeus D., Rivera, Adovich S., Cheng, Kent Jason G., Rand, Kim, Purba, Fredrick Dermawan, Luo, Nan, Zarsuelo, Ma-Ann, Genuino-Marfori, Anne Julienne, Florentino-Fariñas, Irene, Guerrero, Anna Melissa, Lam, Hilton Y.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-09-2022; Springer Nature B.V
• Subjects: Chronic illnesses; Consent; Cost analysis; Data collection; Health care; Institutionalization; Medicine; Medicine & Public Health; Mobility; Population; Preferences; Public Health; Quality of life; Quality of Life Research; Sociology; Valuation; Philippines; QALY; Developing countries; EQ-5D-5L; Utility weights; Hybrid mathematical modeling
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-022-03143-w

Background
The Philippines has recommended the use of Quality-Adjusted Life Years (QALYs) in government health technology assessments (HTA). We aimed to develop a value set for the EQ-5D-5L based on health preferences of the healthy general adult population in the Philippines.
Methods
Healthy, literate adults were recruited from the Philippine general population with quota targets based on age, sex, administrative region, type of residence, education, income, and ethnolinguistic groups. Each participant’s preference was elicited by completing Composite Time Trade-Off (C-TTO) and Discrete Choice Experiment (DCE) tasks. Tasks were computer-assisted using the EuroQol Valuation Technology 2.0. To estimate the value set, we explored 20- and 8-parameter models that either use c-TTO-only data or both c-TTO and DCE (also called hybrid models). Final model choice was guided by principles of monotonicity, out-of-sample likelihood, model fit, and parsimony.
Results
We recruited 1000 respondents with demographic characteristics that approximate the general population such as 49.6% Female, 82% Roman Catholic, 40% in urban areas, and 55% finished high school. None of the 20-parameter models demonstrated monotonicity (logical worsening of coefficients with increasing severity). From the 8-parameter models, the homoscedastic TTO-only model exhibited the best fit. From this model, mobility and pain/ discomfort had the highest effect on utilities.
Conclusion
The selected model for representing the Philippine general population preferences for EQ-5D-5L health states was an 8-parameter homoscedastic TTO-only model. This value set is recommended for use in QALY calculations in support of HTA-informed coverage decisions in the Philippines.