Russian EQ-5D-3L value set: population norms for the utility index in adults

Background. EQ-5D-3L is a standard instrument for describing health and assigning utility values using country-specific value sets that reflect population health-state preferences. It describes health across five dimensions (5D), each with three levels of problems (3L), yielding 243 possible health states. Since cultural and social factors influence health-state preferences, the same health state may have different utility values across countries. A Russian EQ-5D-3L value set has been developed; however, population norms based on this national value set have not yet been established. Objective: To calculate utility indices for all 243 EQ-5D-3L health states using the Russian value set, compare them with the corresponding United Kingdom (UK) values, and establish population norms for the utility index among Russian adults, compared with norms based on the UK value set. Material and methods. The Russian value set was applied to a fully de-identified dataset from 1,565 respondents to a nationwide Russian survey conducted in 2017. Population norms for the utility index were calculated for the overall sample, men, women, and seven age groups and compared with corresponding norms based on the UK value set. The overall norm was also descriptively compared with that reported in a Moscow study and with published norms from other countries. Results. Across the 243 health states, utility indices based on the Russian EQ-5D-3L value set ranged from –0.502 to 1.000 and were higher than the corresponding UK values for 242 states. For health state 11113, representing severe anxiety or depression with no problems in the other dimensions, the respective values were 0.821 and 0.414. In the nationwide Russian sample, the mean utility index was 0.912 for the Russian value set and 0.835 for the UK value set; the corresponding utility deficits relative to full health were 0.088 and 0.165, respectively. The difference between men and women decreased from 0.061 to 0.036, while the difference across age groups decreased from 0.400 to 0.242. The nationwide value of 0.912 was close to the Moscow value of 0.907 and fell within the range of published population norms for countries with national time trade-off (TTO)-based value sets (0.856–0.958). Conclusion. The Russian EQ-5D-3L value set affects not only the mean utility index but also the relative weights assigned to individual dimensions, the distribution of index values, and differences between population groups. Use of the appropriate national value set is essential for calculating quality-adjusted life-years and conducting cost-effectiveness analyses. The resulting population norms can be used to compare patients with the general population of the same sex and age, compare the burden of different diseases, and assess changes in quality of life over time.