The ‘Online elicitation of Personal Utility Functions’ (OPUF) is a new method for valuing health states. It is based on compositional preference elicitation techniques. In contrast to established, decompositional techniques, such as time trade-off or discrete choice experiment (DCE), the OPUF approach does not require hundreds or thousands of respondents, but allows estimating utility functions for small (patient) groups and even on the individual level. The objective of this study was to generate and compare EQ-5D-5L value sets on the societal-, group-, subgroup-, and individual-level.

A demonstration version of the EQ-5D-5L OPUF Tool is available at: https://eq5d5l.me. It broadly consists of three valuation steps: dimension weighting, level rating, and anchoring. Responses were combined on the individual level to construct personal utility functions. Every respondent also completed three conventional DCEs. Preferences were aggregated across individuals to estimate a societal and various group-level preference functions. We then assessed the heterogeneity of preferences between groups using descriptive statistics and k-means cluster analysis.

A representative sample (n = 1,000) of the United Kingdom (UK) population was recruited through the prolific online platform. On average, it took participants about 7 minutes to complete the survey. Data of 874 respondents were included in the analysis. For each respondent, we constructed a personal EQ-5D-5L value set. The derived utility functions predicted respondents’ choices in DCE with an accuracy of 78 percent. On the societal level, the predicted values for the EQ-5D-5L health states ranged from -0.376 to 1. Health state preference varied greatly between groups. This was largely due to differences in the anchoring, while there was near consensus on the relative importance of the five EQ-5D dimensions between groups. Demographic characteristics explained only a small proportion of the variability.

Using the OPUF approach, we were not only able to estimate a new EQ-5D-5L value set for the UK, but also to examine the underlying individual preferences in an unprecedented level of detail.