Implications for CEA

There is hardly any evidence on the implications for cost-effectiveness ratios when switching from EQ-5D-3L to EQ-5D-5L. Some work has been done for England, but researchers had no paired 3L and 5L data, a gap they filled with mapping. These indirect methods attribute to uncertainties, in particular in view of concerns about the validity of estimates of QALY gains when based on mapping algorithms. It is difficult to disentangle difference that relate to the mapping and ‘real’ difference between 3L and 5L responses.