Age-Related Differences in Health Utility Values among the General Population: A Systematic Review of EQ-5D Measures Studies

Abstract

Introduction: Health technology assessment (HTA) supports evidence-based decision-making. Cost-utility analysis is a commonly used method in HTA that utilises generic metrics such as quality-adjusted life years (QALYs). QALY is a measure derived from individuals’ preferences for different health states, with these preferences represented as utility values. However, these values might vary among age groups, leading to equity concerns in healthcare resource allocation. Given the globally ageing demographic, understanding the age-utility relationship becomes essential. Objectives: A systematic review was carried out to assess age’s impact on EQ-5D utility values in the general population. Methods: Our search used the comprehensive pearl growing approach and database searching. We included studies that analysed the effect of age on EQ-5D utility values in the general population. We excluded qualitative, non-English, and non-EQ-5D instrument studies and those on specific patient groups. Quality was appraised using the Joanna Briggs Institute tool, and a narrative synthesis was used. Results: Of the 28 studies reviewed, primarily from Europe and the Americas, the average age of participants ranged from 34.1 and 47.7 years. Around 46% (N=13) linked older age with lower utility values; 28% (N=8) showed the opposite; and 25% (N=7) found no consistent age-utility correlation. Discussion: We identified age as a significant influencer on utility values within EQ-5D. The quality of evidence reviewed varied; some lacked robust valuation protocols or adequate age representation. Our results align with prior studies on other utility instruments, raising essential ethical implications for healthcare distribution and highlighting the need for more tailored research.