Researchers from the University of Sheffield are leading work that will significantly influence how healthcare treatments are assessed and approved across the UK.
The researchers, based at the Sheffield Centre for Health and Related Research (SCHARR), have developed a new way of capturing how patients value different health outcomes, an essential step in determining whether new treatments offer value for money and the implications of this.
In England, the National Institute for Health and Care Excellence (NICE) evaluates whether new healthcare interventions are cost-effective before recommending them for use in the NHS. A key part of this process is measuring health benefits using a standard tool called EQ-5D.
The EQ-5D is a widely used patient-reported questionnaire that measures health-related quality of life. It covers five dimensions: mobility, self care, usual activities, pain/discomfort and anxiety/depression.
Until now, NICE has relied on values derived in the 1990s using an older version of this tool. The Sheffield team has created a new ‘value set’ for the latest version, EQ-5D-5L, reflecting current public preferences and using modern research methods.
To build the new value set, researchers carried out interviews with 1,200 members of the UK public, both online and in person. Using a technique known as ‘time trade-off’, participants were asked to consider trading years of life for improved health. The responses allowed the researchers to understand how people value different aspects of health-related quality of life.
The findings suggest that public attitudes to health may have shifted over time. For example, mental health is now given greater importance compared to earlier value sets developed decades ago.
Professor Donna Rowen, Professor of Health Economics and project lead said: “The UK EQ-5D-5L value set has used state-of-the-art methods to ensure the values represent current preferences of the UK public around how different aspects of their health are valued. Implementation of the value set by NICE would enable these findings to be used to shape decisions, representing an improvement on the use of values that are now outdated.”
In addition to this, over the past 18 months, researchers in SCHARR have been working on several projects designed to understand the impact of moving from the EQ-5D-3L to EQ-5D-5L value set, including the provision of analytical tools to do so. Part of this work was carried out within the NIHR (National Institute for Health and Care Research) Policy Research Unit in Economic Methods of Evaluation of Health and Care Interventions (EEPRU), with additional contributions undertaken through the NICE Decision Support Unit (NICE DSU).
Research was designed to answer questions decision makers, like NICE, needed to know, like, ‘how will decisions to approve new health technologies and medicines pricing be affected?’. This work forms a key component of the consultation exercise NICE is currently running.
Professor Allan Wailoo, Professor of Health Economics, research programme lead said: “NICE makes decisions that affect the health of millions of people. Healthcare policy makers like NICE cannot make optimal decisions without accurate data on how patient health stands to benefit from the money they will spend. Our work was designed with and for NICE and directly informs these important policy decisions.”
The value set research is the result of collaboration between researchers at the University of Sheffield and partners from institutions including Bangor University, the University of Leeds, the University of Oxford, Queen’s University Belfast, and industry organisations, including the EuroQol Research Foundation, which oversees the EQ-5D instrument.
If adopted, the new value set will modernise how health benefits are assessed in the UK, potentially reshaping which treatments are made available to patients in the future.