Quality-adjusted life expectancy norms for the English population

Abstract

AbstractObjectiveThe National Institute for Health and Care Excellence in England has proposed severity-of-disease modifiers that give greater weight to health benefits accruing to patients who experience a larger shortfall in quality-adjusted life years (QALYs) under current standard of care compared to healthy individuals. This requires an estimate of quality-adjusted life expectancy (QALE) of the general population by age and sex. Previous QALE population norms are based on nearly 30-year old assessments of HRQoL in the general population. This study provides updated QALE estimates for the English population by age and sex.MethodsEQ-5D-5L data for 14,412 participants from the Health Survey for England (waves 2017 and 2018) were pooled and HRQoL population norms were calculated. These norms were combined with official life tables from the Office for National Statistics for 2017-2019 using the Sullivan method to derive QALE estimates by age and sex. Values were discounted using 0%, 1.5% and 3.5% discount rates.ResultsQALE at birth is 68.04 QALYs for men and 68.48 QALYs for women. These values are lower than previously published QALE population norms based on older HRQoL data. Additional data tables and figures are made available through an interactive web application: https://r4scharr.shinyapps.io/shortfall/.ConclusionsThis study provides new QALE population norms for England that serve to establish absolute and relative QALY shortfalls for the purpose of health technology assessments.