Concept Architecture
Concept
Theoretically, a Value Set is a collection of preference-based numerical values assigned to the health states described by a standardised health-related quality-of-life instrument. It is grounded in expected utility theory, welfare economics and health-state valuation, enabling descriptive health profiles to be translated into measures of health utility. In health economics, value sets provide the link between patient-reported health status and the utility values required for cost-utility analysis.
Mathematically, a value set is represented by a scoring function or lookup structure derived from statistical modelling of preference elicitation data. Health-state values are commonly estimated from time trade-off, standard gamble or discrete choice observations using regression models. The resulting parameters define the relationship between health-state characteristics and utility, permitting prediction for directly and indirectly valued states.
In practice, a value set is applied to health-state profiles collected in clinical trials, observational studies or decision models. Analysts generally select a value set developed for the jurisdiction and reference population relevant to the reimbursement decision. The resulting utilities are used to estimate changes in health-related quality of life, quality-adjusted life-years and incremental cost-effectiveness.
Purpose
Used to assign preference-based utility values to health-state profiles, enabling calculation of quality-adjusted life-years and cost-utility outcomes.
Mathematical Formulae
Primary Formula
U(s) = f(x?, x?, ..., x?; ?)
where:
- U(s) = utility assigned to health state s
- x?, ..., x? = health-state dimension and severity indicators
- ? = estimated value-set parameters
Supporting Formulae
Linear scoring model:
U(s) = ?? + ???x?
Utility decrement model:
U(s) = 1 ? ?d?x?
Quality-adjusted life-years:
QALYs = ?u? ? ?t
Related Mathematical Methods
- Health-State Valuation
- Tariff Estimation
- Time Trade-Off
- Standard Gamble
- Discrete Choice Modelling
- Regression Analysis
Example
A patient reports a health state associated with utility 0.68 in the relevant national value set. After treatment, the patient reports a state valued at 0.82.
Utility Gain = 0.82 ? 0.68 = 0.14
If the improvement persists for three years:
QALY Gain = 0.14 ? 3 = 0.42 QALYs
The value set enables the observed change in descriptive health status to be incorporated into a cost-utility analysis.
Excel Implementation
| Function | Example Formula | Health Economics Application |
|---|---|---|
| XLOOKUP | =XLOOKUP(B2,HealthStateRange,UtilityRange) | Retrieves the value assigned to a complete health-state profile. |
| SUMPRODUCT | =SUMPRODUCT(IndicatorRange,CoefficientRange) | Applies estimated value-set coefficients. |
| INDEX | =INDEX(UtilityRange,MATCH(B2,HealthStateRange,0)) | Retrieves a utility where XLOOKUP is unavailable. |
| LET | =LET(Base,1,Dec,SUM(C2:G2),Base-Dec) | Calculates a value-set score from decrements. |
| SUMPRODUCT | =SUMPRODUCT(UtilityRange,TimeRange) | Calculates QALYs using value-set utilities. |
VBA (Optional)
VBA can automate value-set scoring for large health-state datasets and generate patient-level utility and quality-adjusted life-year outputs.
Sources
- Brazier J, Ratcliffe J, Salomon JA, Tsuchiya A. Measuring and Valuing Health Benefits for Economic Evaluation. Oxford University Press.
- Dolan P. Modeling valuations for EuroQol health states. Medical Care.
- Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health-related quality of life: an EQ-5D-5L value set for England. Health Economics.
- NICE. Health Technology Evaluation Manual.
- ISPOR Good Research Practices for Health-State Utility Estimation.
Related Concepts (2)
Institutional Perspectives (3)
- NICE
EQ-5D-3L Value Set for the Reference Case (5L Mapped to 3L)
The reference case has used the EQ-5D-3L value set for England; NICE did not recommend the 2018 English EQ-5D-5L value set on quality grounds, requiring 5L data to be mapped to the 3L value set (van Hout et al. crosswalk) for utilities. A new UK EQ-5D-5L value set has since been produced and NICE has been reviewing adoption, so the preferred value set is subject to update.
NICE Position Statement on the EQ-5D-5L Value Set for England (2019); NICE manual (PMG36)View source → - ZIN
EQ-5D-5L With the Dutch Value Set
Utilities for QALY calculation should be derived using the EQ-5D-5L with the Dutch (country-specific) value set as the preferred instrument.
Zorginstituut Nederland, Guideline for Economic Evaluations in Healthcare (2024)View source → - CADTH (CDA-AMC)
Canadian-Specific Value Sets Recommended
Validated generic health-state classification systems with Canadian-specific value sets are recommended for estimating QALYs; no single instrument is mandated, though the EQ-5D-5L (with the Canadian value set) is commonly used.
CADTH (now CDA-AMC), Guidelines for the Economic Evaluation of Health Technologies: Canada, 4th Edition (2017)View source →
Library
Publications
4
Measuring and Valuing Health Benefits for Economic Evaluation — Brazier, Ratcliffe, Salomon & Tsuchiya, 2nd Edition ed., 2017 (Oxford University Press)
The comprehensive text on the measurement and valuation of health benefits for economic evaluation — defining health, valuation techniques (time trade-off, standard gamble), whose values to use, preference-based measures (EQ-5D, SF-6D), and the construction of QALYs.
BookView source →NICE DSU Technical Support Document 8: An Introduction to the Measurement and Valuation of Health for NICE Submissions — Brazier, Rowen, TSD 8 ed., 2011 (NICE Decision Support Unit (University of Sheffield))
An introduction to the measurement and valuation of health for NICE submissions — the QALY, health-state utility values, generic preference-based measures, and the requirements of the NICE reference case.
NICE DSU Technical Support Document 9: The Identification, Review and Synthesis of Health State Utility Values from the Literature — Papaioannou, Brazier & Paisley, TSD 9 ed., 2011 (NICE Decision Support Unit (University of Sheffield))
Guidance on systematically identifying, reviewing and synthesising health-state utility values (HSUVs) from the published literature for use in cost-utility models.
The EQ-5D-5L Valuation Study in Egypt — Al Shabasy, Abbassi, Finch, Roudijk, Baines and Farid, 40:65–77 ed., 2022 (PharmacoEconomics)
National EQ-5D-5L valuation study providing preference weights for QALY calculation in Egypt.
Journal ArticleView source →
Tools & Resources
2
EQ-5D Index Calculator (Economics Network) — The Economics Network / healtheconomics.org, Spreadsheet tool ed., 2023 (Economics Network, University of Bristol)
A free downloadable spreadsheet calculator that converts EQ-5D descriptive-system responses into index utility values, widely used as a teaching and quick-reference tool for QALY estimation.
Excel ToolView source →EQ-5D Value Sets and Analysis Tools — EuroQol Research Foundation, Current online resource ed., 2026 (EuroQol Research Foundation)
Official resources for selecting and applying instrument- and country-specific EQ-5D value sets used in QALY estimation.
Web ResourceView source →
Frequently Asked Questions (6)
What is a value set?
The complete collection of utility weights from a population valuation study, used to convert every combination of instrument responses into a utility score.
Source: Brazier et al. 2007
Why does a value set need to cover states never directly valued?
A descriptive system can define far more states than any survey could present to respondents, so a value set must supply a value for every possible combination, including the many that no one was ever asked to judge. It does this through a model fitted to the states that were valued, which predicts values for the rest. The value set is therefore a formula spanning the whole state space, not just a table of directly measured points. Brazier and colleagues (2007) explain this need for modelled coverage.
Source: Brazier et al. 2007
How is a value set produced?
A value set is produced by eliciting valuations of a sample of the instrument's health states from a representative population, using a method such as the time trade-off or discrete choice experiment, and modelling these valuations to estimate weights for every state, including those not directly valued. The model extends the sample valuations across the full descriptive system. The resulting weights, covering all states, constitute the value set applied to score respondents.
Source: Brazier et al. 2007
How is a value set applied?
A value set is applied by taking a respondent's levels on the instrument's dimensions and combining the corresponding weights according to the value set's scoring rule into a single utility. Because the value set covers every combination of levels, any described health state can be scored. Applying the value set converts a health description into the utility used to weight time in quality-adjusted life years, which is how instruments yield values for economic evaluation.
Source: Brazier et al. 2007
Why does the choice of value set matter?
The choice of value set matters because different value sets, from different populations, countries, or methods, assign different utilities to the same described state, so the quality-adjusted life years and the conclusions of an evaluation depend on which is used. Decision-making bodies often specify a value set for their population to ensure consistency. Because it directly determines the utilities, the value set applied is reported, and its origin is recognised as materially affecting results.
Source: Brazier et al. 2007
What are the limitations of a value set?
A value set reflects the preferences of the sample from which it was elicited, at a point in time, so it may not represent other populations or remain current, and a value set may not exist for every instrument or country. The modelling that extends valued states to all states introduces assumptions, and different elicitation methods yield different value sets. These features mean utilities are conditional on the value set used, which is stated and its limitations acknowledged.
Source: Brazier et al. 2007
Trust Record
Verified by Dr Darrin Baines
British health economist
Professional identity: darrinbaines.org
Verification date: 2 Sep 2025
Content version: 1.0.0
Canonical Identity
- Persistent URI
- https://healtheconomics.wiki/concept/value-set
- Term code
- HE-EE-HU-083
Stable URI · Machine-readable · Resolvable · CC BY 4.0