Journal
JOURNAL OF HEALTH ECONOMICS
Volume 55, Issue -, Pages 139-152Publisher
ELSEVIER
DOI: 10.1016/j.jhealeco.2017.06.013
Keywords
EQ-5D; Ordinal response; Copula; Mixture models; Rheumatoid arthritis; Mapping; Cost-effectiveness
Funding
- Medical Research Council [MR/L022575/1]
- ESRC funding through the Understanding Society project
- Centre for Micro -Social Change [ES/K005146/1, ES/L009153/1]
- Economic and Social Research Council [ES/L009153/1, ES/H00811X/1] Funding Source: researchfish
- Medical Research Council [MR/L022575/1] Funding Source: researchfish
- ESRC [ES/L009153/1, ES/H00811X/1] Funding Source: UKRI
- MRC [MR/L022575/1] Funding Source: UKRI
Ask authors/readers for more resources
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. (C) 2017 The Authors. Published by Elsevier B.V.
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