Econometric modelling of multiple self-reports of health states: The switch from EQ-5D-3L to EQ-5D-5L in evaluating drug therapies for rheumatoid arthritis

Mónica Hernández-Alava and Stephen Pudney
Authors registered in the RePEc Author Service: Monica Hernandez Alava

Journal of Health Economics, 2017, vol. 55, issue C, 139-152

Abstract: EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but the consequences of this change are uncertain. We develop a multi-equation ordinal response model incorporating a copula specification with normal mixture marginals to analyse joint responses to EQ-5D-3L and EQ-5D-5L in a survey of people with rheumatic disease, and use it to generate mappings between the alternative descriptive systems. We revisit a major cost-effectiveness study of drug therapies for rheumatoid arthritis, mapping the original EQ-5D-3L measure onto a 5L valuation basis. Working within a comprehensive, flexible econometric framework, we find that use of simpler restricted specifications can make very large changes to cost-effectiveness estimates with serious implications for decision-making.

Keywords: EQ-5D; Ordinal response; Copula; Mixture models; Rheumatoid arthritis; Mapping; Cost-effectiveness (search for similar items in EconPapers)
JEL-codes: C35 C83 D61 H51 I10 (search for similar items in EconPapers)
Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:jhecon:v:55:y:2017:i:c:p:139-152

DOI: 10.1016/j.jhealeco.2017.06.013

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