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Value Health. 2016 Jun;19(4):343-52. doi: 10.1016/j.jval.2016.01.003. Epub 2016 Mar 30.

Dutch Tariff for the Five-Level Version of EQ-5D.

Author information

Institute for Medical Technology Assessment, Erasmus University of Rotterdam, Rotterdam, the Netherlands. Electronic address:
Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands; Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, the Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; National Institute of Public Health and the Environment, Bilthoven, the Netherlands.
Faculty of Behavioural, Management and Social Science, University of Twente, Enschede, the Netherlands.
Institute of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University of Rotterdam, Rotterdam, the Netherlands.



In 2009, a new version of the EuroQol five-dimensional questionnaire (EQ-5D) was introduced with five rather than three answer levels per dimension. This instrument is known as the EQ-5D-5L. To make the EQ-5D-5L suitable for use in economic evaluations, societal values need to be attached to all 3125 health states.


To derive a Dutch tariff for the EQ-5D-5L.


Health state values were elicited during face-to-face interviews in a general population sample stratified for age, sex, and education, using composite time trade-off (cTTO) and a discrete choice experiment (DCE). Data were modeled using ordinary least squares and tobit regression (for cTTO) and a multinomial conditional logit model (for DCE). Model performance was evaluated on the basis of internal consistency, parsimony, goodness of fit, handling of left-censored values, and theoretical considerations.


A representative sample (N = 1003) of the Dutch population participated in the valuation study. Data of 979 and 992 respondents were included in the analysis of the cTTO and the DCE, respectively. The cTTO data were left-censored at -1. The tobit model was considered the preferred model for the tariff on the basis of its handling of the censored nature of the data, which was confirmed through comparison with the DCE data. The predicted values for the EQ-5D-5L ranged from -0.446 to 1.


This study established a Dutch tariff for the EQ-5D-5L on the basis of cTTO. The values represent the preferences of the Dutch population. The tariff can be used to estimate the impact of health care interventions on quality of life, for example, in context of economic evaluations.


EQ-5D-5L; discrete choice experiment; time trade-off; utility measurement

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