Modular update to NICE manuals EQ-5D-5L value set: Evidence review document

Use of the EQ-5D-5L descriptive system has been increasing because it captures health-related quality of life more accurately and sensitively than the EQ-5D-3L (Buchholz et al. 2018, Devlin et al. 2018b). But in the absence of an accepted 5L value set for the UK, NICE's methods currently rely on mapping 5L descriptive system data onto the 3L value set. This approach, although unavoidable until now, has several limitations. First, the 3L value set is unlikely to reflect current societal preferences about health-related quality of life, because the data were collected in the early 1990s (Dolan 1997). Much has changed since then: the UK population demographics are different, healthcare has advanced, and public awareness of health issues has evolved. This means that what people consider important about their health is likely to be different now, and this is captured in the new 5L value set. Research comparing older and more recent EQ-5D value sets in other countries has demonstrated substantial changes in utility values over time, and researchers have highlighted the importance of periodically updating value sets (Liao et al. 2026, Norman et al. 2025, Roudijk and Jonker 2026). The change in population demographics also means the 3L value set may no longer satisfy NICE's requirement for valuation studies to reflect the general population. Finally, the methods for eliciting health state preferences, and the approaches to modelling preference data, have improved since the 1990s (Norman et al. 2025, Oppe et al. 2014, Ramos-Goñi et al. 2017, Rowen et al. 2022). These more reliable methods have been used to develop the new 5L value set, and the appropriate quality assurance of the data and modelling has been completed.

The EQ-5D-5L value set study was overseen by a steering group that included academics and representatives from NICE, NHS England, the Department of Health and Social Care (DHSC) and EuroQol (the international non-profit research foundation that develops, distributes and licenses the EQ-5D instruments). In addition, an independent quality control team, which included valuation and modelling experts not involved in the study team or steering group, reviewed the study protocol, quality assured the data at several predefined timepoints, and checked the modelling for errors and reproducibility (EuroQol 2020). Patients and members of the public also helped shape how the study was designed, carried out and interpreted. Their views were invited during several structured sessions between the study team and representatives nominated by NICE's people and communities involvement and engagement team. The study's quality control team and steering group concluded that the data collected was of high quality and that the modelling approach was appropriate and well justified. The study has been peer reviewed and published in Value in Health (Rowen et al. 2026).

In summary, the case for adopting the UK value set is strong. It represents a more accurate depiction of current societal preferences and will allow NICE to more accurately account for the health benefits of technologies and other interventions.