The aim of this study was to explore the feasibility of different health-related quality-of-life valuation methods in a new setting. Based on a small feasibility study of 100 young Russians, we trialed different methodologies and identified key differences that have implications for the development of health technology assessment in Russia.
In face-to-face interviews, respondents completed a series of health self-assessments based on a modified version of the EQ-5D-3L, visual analogue scale, time tradeoff, standard gamble, and best-worst scaling methodologies, covering actual and hypothetical health states.
We found that (1) the visual analogue scale produced lower health valuations and fewer logical inconsistencies than either time trade-off or standard gamble methodologies; (2) initial health states can be decisive in determining values assigned to health improvements; (3) respondents evaluate abstract health states more positively than their own actual health states; (4) there is evidence consistent with the hypothesis that actual and hypothetical health state valuation, using EQ-5D-3L, is an artifact of understanding rather than preference and that the incorporation of additional levels may therefore be no panacea if the dimensions themselves overlook important attributes; and (5) the country context is important in determining how respondents relate to the survey tools and how those survey tools are translated and delivered.
Russia is commencing its health technology assessment journey and should proceed cautiously as it moves toward the valuation of health benefits. These results suggest a useful framework for a more in-depth development of health valuation methodologies in Russia.
Health-related quality of life is becoming the standard measure of personal well-being and human’s health worldwide. Indicators of the population quality of life allow taking into account the subjective incidence, which is often overlooked during routine medical care. In Russia, the health-related quality of life is becoming particularly relevant in connection with the problems of an ageing population, the development of national strategies and programs in the social and healthcare systems, and the increasing prevalence of chronic diseases. The basis of the HRQoL measurement should be based on a proven and reliable methodology that generates comparable estimates of human well-being. Like any complex subjective indicator, HRQoL does not have an unambiguous direct method of measurement. The aim of this paper is a comprehensive description of the methodology for conducting and presenting the results of the study of the HRQoL using the European Quality of Life Questionnaire, EQ–5D. The paper discusses the measurement of HRQoL as a critical component of a modern health care system, describes in detail the administration of HRQoL data using the EQ–5D–3L questionnaire, and provides a methodology for analyzing and presenting the collected data in studies of population and patient health. We address the discussion to clinicians, healthcare providers, and researchers dealing with the problems of studying and measuring the health-related quality of life.