Development and validation of the EQ-5D-5L value set among Japanese older adults for health technology assessment

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K17228
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Keio University (2022-2023); Fukushima Medical University (2021)
• Principal Investigator: Yoshioka Takashi 慶應義塾大学, 医学部(信濃町), 特任講師 (00771320)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 健康関連QoL / 医療経済評価 / 高齢者 / 選好に基づく尺度

Outline of Final Research Achievements

An internet survey was conducted on a total of 1,099 men and women aged 65 and above to develop a value set for EQ-5D-5L and examine the impact of individual comorbidities to health utilities. Regarding the development of a value set for the elderly: 240 valid responses were obtained for the composite time trade-off method + discrete choice experiment. A linear mixed model was fitted, considering 1 - health utility value as the outcome variable, dummy variables representing each level of the 5 items as explanatory variables, and respondents as random effects. Regarding disutilities due to comorbidities: For 983 respondents, the decrease in health utility values was calculated using a linear regression model with health utility values as the outcome variable and comorbidities as explanatory variables. This study revealed the development of an EQ-5D-5L value set for the elderly and the decrease in health utility values due to comorbidities in the general elderly population.

Free Research Field

臨床疫学、医療経済学

Academic Significance and Societal Importance of the Research Achievements

本研究により、高齢者の健康効用値が先行研究の日本人一般集団を対象とした研究による推定値とは異なる可能性が示唆された。本研究はインターネット調査という特殊な集団はあるものの、高齢者向けのバリューセットの開発・検証の必要性を示唆している。また、本研究の対象となった高齢回答者のEQ-5D-5Lから間接法で推定した健康効用値は、併存疾患の存在で低下する可能性が確認された。中でも慢性閉塞性肺疾患、変形性関節症、腰痛症で統計的有意性を示した。本研究の健康効用値低下に関する結果は、これらの併存疾患を標的とする医薬品・医療技術の経済評価の基礎資料となりうる重要な知見と言える。