Does the 3L versus 5L choice have impact on CEA?

Evidence on the implications for cost-effectiveness ratios when switching from EQ-5D-3L to EQ-5D-5L is limited. Some work has been done on this, using mapping instead of a direct comparison of the EQ-5D-3L and EQ-5D-5L (see Wailoo et al, 2021), showing that there are differences, but that these differences are not unidirectional between countries. Furthermore, simulation work has shown using directly elicited value sets versus mapped/crosswalked value sets may lead to different results in CEA. (Ben et al, 2023) However, neither of this work provides a comparison of directly elicited EQ-5D-3L and EQ-5D-5L response data and their values, which means that these results are not definitive. Ben, Â. J., van Dongen, J. M., Finch, A. P., Alili, M. E., & Bosmans, J. E. (2023). To what extent does the use of crosswalks instead of EQ-5D value sets impact reimbursement decisions?: a simulation study. The European Journal of Health Economics, 24(8), 1253-1270. Wailoo, A., Alava, M. H., Pudney, S., Barton, G., O’Dwyer, J., Gomes, M., … & Sadique, Z. (2021). An international comparison of EQ-5D-5L and EQ-5D-3L for use in cost-effectiveness analysis. Value in Health, 24(4), 568-574.

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