How we can offer a broader range of benefits for people, their families and carers

Usually, when NICE looks at the cost effectiveness of a healthcare intervention, the benefit of the intervention is measured in terms of how many quality-adjusted life years (QALYs) it provides. The ‘quality’ adjustment is based on a measurement of health-related aspects of quality of life, usually using the EQ-5D instrument.

However, there is some debate that the existing measures of health-related quality of life might not capture important benefits of treatments beyond health-related quality of life, such as independence or improved relationships with friends, family and carers.

So, for the last three years, NICE has been part of a research project investigating how quality of life measures used to evaluate healthcare treatments such as drugs can be extended into areas of social care and public health, with the aim producing a patient-reported outcome measure, suitable for use across these broader areas.

The ‘Extending the QALY’ research project has been led by the School of Health and Related Research (ScHARR) at the University of Sheffield, in collaboration with the University of Kent, the Office of Health Economics and an international team of researchers from the EuroQol Group, and jointly funded by the UK Medical Research Council and the EuroQol Research Foundation.

The project is nearing completion, with final study results expected towards the end of 2021, and a new instrument titled the EQ-HWB (EQ Health and Wellbeing instrument) has been produced. EQ-HWB has been designed as a standardised measure of aspects of health and wellbeing and currently has 25 items, as well as there being a shorter version, called the EQ-HWB-S (EQ Health and Wellbeing Short version), which currently has just 9 items.

The EQ-HWB is currently only being made available to research collaborators, with both versions of the EQ-HWB instrument having been given the status of Experimental Version. At a later stage the EQ-HWB will be made available via the EuroQol website as a Beta Version.

The EQ-HWB is not in development as a replacement for EQ-5D, but as a different patient-reported outcomes instrument that captures a broader range of impacts on people, their families and carers. Further research is planned to validate EQ-HWB and compare it with existing instruments. NICE supports this important research, which will help us to decide whether and how to use EQ-HWB to inform NICE evaluations in future.

For more information, please see the EQ-HWB page on the Euroqol Website.