Mesure de l’utilité attachée aux états de santé : valorisation de l’index d’utilité EQ-5D et évolution de l’échelle actuelle en France

In cost-utility analysis results are often processed in terms of QALY (Quality Adjusted Life Year). The duration of a given health state is weighted with a coefficient calculated based on its associated quality of life. Using such an indicator assumes two things: knowing the health state of the patient and the utility level associated to that state. In this purpose preference-based indexes have been developed. The EQ-5D is one of the most frequently used indexes. It has been developed and validated in many countries, including France, but the French utility function has not been calculated. This function gives a weight to each health state taking into account the local populations’ preferences. In absence of set of national population-based utility weights, a foreign value-set is used. However preferences for different heath states may not necessarily be all-purpose. Several studies have backed up this assumption pointing out that utilities function estimated in different countries could present some differences. Thus, utility values should be developed locally. The dissertation has several objectives: to provide a value-set for the EQ-5D health states in the French context, to develop a revised version of the EQ-5D with 5 levels for each dimension and to test a new valuation method called Scoring.