Comparison of hypothetical and experienced EQ-5D valuations: relative weights of the five dimensions

Purpose EQ-5D tariffs are typically based on general population valuations studies, but whether valuations of experienced health (EH) or hypothetical health (HH) are more appropriate is disputed. Previous comparisons of valuations of EH and HH have focused on absolute differences in dimension-specific regression coefficients. We examined differences in the relative importance attributed to the EQ-5D dimensions between EH and HH valuations of EQ-5D states in the United States. Methods We used the regression model from the US EQ-5D valuation study on EH ratings from the 2000-2003 Medical Expenditure Panel Survey and on HH ratings from the US EQ-5D valuation study conducted in 2001. We then compared patterns in the relative magnitudes of coefficients that corresponded to the five dimensions. Results In the HH model, self-care and pain/discomfort were the most important dimensions, while usual activities were the least important. In the EH model, usual activities were the most important dimension, while self-care was one of the least important. Discussion The findings reveal considerable differences between stated preferences for HH and ratings of EH, particularly for self-care and usual activities. The findings accentuate the importance of the debate about which groups' values should be used in medical priority setting.