Influence of Self-Reported Health Impairments on German EQ-5D-5L Values

The German EQ-5D-5L value set is based on the average preferences of the general population. Nevertheless, in Germany, there is an ongoing debate about the appropriateness of using general population preferences and whether patient preferences should be used instead. Thus, this research aimed to determine the robustness of the German EQ-5D-5L valuation data for the general population compared with those with health impairments. Subgroups were built on the self-reported quality of life, measured with the EQ-5D-5L. To identify which groups significantly influenced the value set, different regression models, including dummy variables for the subgroups, were tested while controlling for preference heterogeneity. Backward selection based on the Akaike information criterion led to significant subgroup dummies, which were analyzed in more detail. For each significant subgroup, the value set model was estimated separately. The models were then compared. Sociodemographics of the subgroups were considered. Three significant dummies were identified: state 11111, severity levels 5 to 7, and self-reported problems with pain/discomfort. The value sets for the 6 subgroups were compared with the national German value set, showing only marginal deviations. The mean absolute deviation ranged from 0.004 to 0.013. No different densities were identified for the decrements of the different value sets. People with self-reported health impairments do not have different EQ-5D-5L health state preferences compared with the German general population. Further research is needed to determine whether the presence of a chronic health condition has a larger influence on health state valuation than the general population. •In Germany, the EQ-5D-5L and its value set are currently not fully accepted for health decision making. There is a discussion over whether value sets should be based on the general populations or of patients’ preferences. This research aimed to contribute to this discussion.•The study shows that self-reported health impairment does not lead to different value sets and that the German EQ-5D-5L value set is robust for people with self-reported health impairments.•Further research is needed concerning whether the “chronification” of a health impairment to a diagnosed chronic disease leads to patients and the general population valuing health states differently.