A new value set for a new era

The Bulletin

Your biweekly update on health economics, policy, and impact

This issue looks at insights on health outcomes and measurement, including the UK EQ-5D-5L value set, LDL-cholesterol-driven cardiovascular disease, and a cognition bolt-on for EQ-5D-5L.

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David Mott, Associate Director

A new value set for a new era

Last week, four astronauts made it back to Earth having completed the first crewed lunar mission since Apollo 17 back in 1972. The EQ-5D value set that has underpinned NICE cost-effectiveness decisions was developed in the early 1990s – nearer to Apollo 17 than to Artemis II. It belongs to a different era.

The UK’s new EQ-5D-5L value set and its adoption will dominate discussions in the UK health economics community for some time – and the impact may be broader than you might expect, as I explore in a recent OHE insight.

Broader questions remain about how we measure and value health outcomes. Is the EQ-5D-5L descriptive system sufficient, or should additional ‘bolt-on’ items – such as cognition – be added to better capture changes in health? And in the era of patient-centricity, should health outcomes still be valued by the general population, rather than patients themselves?

Elsewhere at OHE we’ve recently published a report on the burden of LDL-cholesterol-driven atherosclerotic cardiovascular diseases. And if cost-effectiveness thresholds keep you up at night, our next Masterclass may be just what you need.

A turning point for EQ-5D-5L in the UK

Seven reflections on the UK EQ-5D-5L value set – and what comes next

The publication of the UK EQ-5D-5L value set marks a major shift for health technology assessment, with important implications for how health-related quality of life is valued in NICE appraisals. Early reflections highlight changes in population preferences, potential impacts on ICERs, and wider consequences for severity modifiers, mapping practices, and informal care.

Early implications for NICE and HTA practice

Quantifying the burden of ASCVD

The burden of LDL-cholesterol-driven atherosclerotic cardiovascular diseases

Atherosclerotic cardiovascular disease (ASCVD) remains a leading global health and economic challenge, with LDL-cholesterol identified as a key modifiable driver. The condition accounts for 261 million DALYs and up to Int$1.4 trillion in total annual costs worldwide, with around one-third linked to LDL-C exposure. Much of the burden is concentrated in moderately elevated LDL-C groups, highlighting the potential for prevention-focused strategies.

Evidence on LDL-C’s role in cardiovascular burden

Testing a cognition bolt-on for EQ-5D-5L

Adding a “Cognition Bolt-on” to EQ-5D-5L: Insights from New Research and What’s Next

A cognition bolt-on for EQ-5D-5L is under active development, reflecting growing recognition of cognitive function as a key driver of health-related quality of life. Early analyses suggest that breaking cognition into sub-domains such as memory and concentration may be more informative than a single umbrella measure.

How cognition could shape health measurement

Masterclass: Understanding cost‑effectiveness thresholds in health policy

Discover how cost‑effectiveness thresholds guide real‑world health policy and HTA decisions — from NICE’s values to global practice. Sign up for our upcoming Masterclass on 28 April 2026.

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