The EQ-5D-5L valuation study in Nigeria

Abstract

Purpose: A country-specific EQ-5D-5L value set ensures that health utility estimates reflect national preferences, enabling contextually appropriate health technology assessment (HTA) to inform efficient resource allocation decisions. This study aimed to develop the first EQ-5D-5L value set for Nigeria. Methods: Adult Nigerians were recruited from 12 states using multi-stage stratified quota sampling based on age, sex, and education. Face-to-face interviews were conducted through Computer-Assisted Personal Interviews using the EQ-PVT protocol. The interview comprises 2 main parts: composite time-trade-off (cTTO) and discrete choice experiment (DCE) tasks. The cTTO data were modelled using random intercept, Tobit, linear (heteroskedasticity-corrected), and Tobit (heteroskedasticity-corrected) models. DCE data were analyzed using Mixed Logit Model (MLM). Hybrid models combining the cTTO and DCE data were also estimated. Results: A total of 1,200 interviews were conducted. The Hybrid Tobit model with intercept, corrected for heteroscedasticity, and excluded flagged responses was considered the preferred model. The utility values of the best (11,111), 2nd best (21,111), worst (55,555), and 2nd worst (54,555) health states are 1, 0.963, − 0.733, and − 0.653, respectively. The most important dimension is Pain/Discomfort followed by Anxiety/Depression, Mobility, Usual Activity, and Self-care, respectively. Conclusion: This study provides the first EQ-5D-5L value set for Nigeria, derived from a representative adult population. This value set provides a strong foundation for HTA, supporting evidence-informed policy decisions and advancing progress towards Universal Health Coverage (UHC) in Nigeria and the wider West African region.