1. 1 Modelling valuations for the EQ-5D health states: an alternative model using differences in valuations Jennifer Roberts and Paul Dolan Sheffield Health Economics Group

2. 2 The EQ-5D Mobility Self Care Usual Activities Pain/Discomfort Anxiety/Depression – 3 levels defining problems on each dimension (none, some, a lot).

3. 3 Motivation the original EQ-5D study preference based single index – 42 states (from 243) valued by TTO – i = 2997, j = 12, n = 35,964 – ‘tariff’ produced (Dolan 1997) – predicts mean health state values quite well despite – enormous variation across individual valuations of states

4. 4 Descriptive Statistics for TTO Values StateMeanS.D. 211110.8780.226 111120.8290.286 221120.6650.372 222220.5000.478 133110.3460.555 21133-0.0630.594 33333-0.5430.412

5. 5 Differences in Health States State AState BNDIF(A-B)SD% Neg99%CI 2211211211321-0.2210.36891.3 87.295.4 1131211122148-0.1880.46381.1 72.889.4 2233121323165-0.1570.53069.1 59.878.4 1112221111307-0.1280.32385.3 80.190.5 3332121133190-0.0920.63560.0 50.869.2 1121121111289-0.0200.22074.4 67.881.0 1212112211139-0.0140.23570.5 60.580.5 2332112223198-0.0140.54758.6 49.667.6 11131122231850.0110.59359.5 50.268.8

6. 6 Agreement with pair wise ranking of states

7. 7 The data for the new tariff model all respondents valued 33333 plus 11 others – 2 very mild (n  1200) – 3 each from mild, moderate and severe (n ~ 750) consider each respondents value of each state as the difference from their value for 33333 – i = 2997, j = 11, n = 32,967 – random effects model used

8. 8 Tariff Results C-0.201 DIFMOB10.320DIFPAIN10.372 DIFMOB20.391DIFPAIN20.491 DIFSC10.179DIFMOOD10.271 DIFSC20.280DIFMOOD20.356 DIFUA10.084ANY13-0.125 DIFUA20.156 R 2 within0.554No > |0.05)8 MAE0.03No > |0.10|1

9. 9 Comparing the old and new tariffs

10. 10 Conclusion Lack of consensus on ordering of states has implications for policy decisions … Two models are similar in structure and findings New model has better predictive ability Some important differences arise – difference in health change given by the two tariffs could be as much as 0.245 Which (if any) is the right model?