Testing the Valuation of the EQ-5D-Y-5L in Adults and Adolescents: Results From a 5-Country Study and Implications for the Descriptive System

Objectives The EQ-5D-Y-5L (Y-5L) is a new health-related quality-of-life instrument for children and adolescents. Value sets for the Y-5L are planned. This article aimed to test the ability of adult and adolescent respondents to differentiate the ordinal levels of the Y-5L in valuation tasks and to explore the characteristics of stated preferences for the Y-5L between adults and adolescents. Methods We collected latent-scale discrete choice experiment data via an online survey of adults (≥18 years) and adolescents (12-17 years) in Australia, Canada, China, The Netherlands, and Spain. A D-Efficient design consisting of 192 choice pairs was grouped into 16 blocks of 12 choice tasks per respondent. We used mixed-logit models to analyze the data and incremental dummies to represent movements from a less-severe level to its consecutive more-severe level. Results We did not observe preference inversions in adults or adolescents (ie, no statistically significant positive coefficients on the incremental dummies). Adults showed similar preferences for the Y-5L in terms of dimension importance: Pain/Discomfort was considered the most important dimension in all countries except for China; Looking After Myself and Usual Activity were the least important dimensions. In contrast, Mobility was considered the most important dimensions by adolescents in Canada, Spain, and China. Conclusions Adults could differentiate between the Y-5L level labels in valuation tasks, whereas more randomness was observed in adolescents’ choices. Observed differences between adult and adolescent stated preferences for the Y-5L raise questions about how these preferences should be reflected in cost-effectiveness analysis.