Peruvian Valuation of the EQ-5D-5L: A Direct Comparison of Time Trade-Off and Discrete Choice Experiments

GIBBONS, LUZ; CRAIG, BENJAMIN M.; BELIZÁN, MARÍA; STOLK, ELLY; AUGUSTOVSKI, FEDERICO; REYES, NORA; TEJADA, ROMINA A.

VALUE IN HEALTH

WILEY-BLACKWELL PUBLISHING, INC

Año: 2020 vol. 23 p. 880 - 888

1098-3015

Objectives: (1) To produce Peruvian general population EQ-5D-5L value sets on a quality-adjusted life-year scale, (2) to investigate the feasibility of a ?Lite? protocol less reliant on the composite time trade-off (cTTO), and (3) to compare cTTO and discrete choice experiment (DCE) value sets. Methods: A random sample of adults (N = 1000) in Lima, Arequipa, and Iquitos did a home interview; 300 were randomly selected to complete 11 cTTOs first. All respondents completed a DCE, including 10 latent-scale pairs (A/B) with 5 EQ-5D-5L attributes, and 12 matched pairs (A/B and B/C) with 5 EQ-5D-5L and one lifespan attributes. We estimated a cTTO heteroscedastic tobit (N = 300) model and 3 DCE Zermelo-Bradley-Terry models (N = 300, 700, and 1000). Results: Each model produced a consistent value set (20 positive incremental parameters). Nevertheless, their lowest quality-adjusted life-year values differed greatly (cTTO: ?1.076 [N = 300]; DCE: ?0.984 [300], 0.048 [700], ?0.213 [1000]). Compared with the cTTO, the DCE (N = 300) produced different parameters (Pearson´s correlation = 0.541), fewer insignificant parameters (0 vs 8), and fewer values less than 0 (26% vs 44%). Compared with the DCE (N = 300), the DCE (N = 700) produced higher values but similar parameters (Pearson´s correlation = 0.800). Conclusions: Besides producing EQ-5D-5L value sets for Peru, the results casts doubt about the feasibility of a Lite protocol like the one in this study. Additionally, fundamental differences between cTTO and DCE?without the existence of a gold standard?need further clarification. The choice between the two rational value sets produced in the current study is a matter of judgment and may have substantial policy implications.