We have launched a public consultation on the proposed adoption of the new EQ-5D-5L value set which will help us to make more accurate assessments of how treatments improve health-related quality of life.

What is the EQ-5D-5L? 

The EQ-5D is a short questionnaire used to understand how a person’s health affects their quality of life. It is used in health research and to help inform decisions about healthcare treatments.  

The questionnaire asks people to rate themselves across 5 areas of daily life: mobility (moving around), self-care (washing, dressing), usual activities (work, study, housework), pain or discomfort, and anxiety or depression.  

For each area, people choose a response from either 3 or 5 options ranging from "no problems" to "extreme problems”. The questionnaire that uses 3 options is known as EQ-5D-3L and the one that uses 5 options is called EQ-5D-5L. 

There are lots of other questionnaires that researchers can use to measure health-related quality of life, but the EQ-5D is NICE’s preferred measure.  

What is a value set?

The responses from the EQ-5D-5L create a health profile that gets converted into a single number (called a ‘utility value’) using a mathematical model called a value set. The value set comes from asking the general public to judge how good or bad different health states would be.   

Utility values help healthcare decision-makers compare different treatments and understand their impact on health-related quality of life. They are combined with information about how a treatment extends length of life, which we express as quality-adjusted life years (QALYs). Utility values and QALYs are part of the information we use in cost-effectiveness models to assess whether a new treatment provides value for money to the taxpayer. In other words, whether its benefits justify its costs.  

Will the new value set be introduced at the same time as the new thresholds?

No. Although the change to the value set was announced at the same time as the change to our thresholds, the timelines for adoption are different. We aim to start applying the new thresholds from April 2026 following the DHSC consultation earlier this year.  

Before we can start applying the new EQ-5D-5L value set, the value set had to be published and we then need to run a consultation on changes to our methods before we publish updated manuals and implement the change. We expect this to take several months from when the value set was published.  The consultation will include the proposed changes to our manuals and the results of two impact assessments, looking at how the EQ-5D-5L value set might affect: 

• the outputs of the cost effectiveness models that NICE uses in our evaluations, including estimates of QALYs and incremental cost-effectiveness ratios 

• the number of decisions qualifying for the severity modifier, and how it changes absolute and proportional QALY shortfall estimates. 

We have also considered whether the change to our methods will have any impact on equalities and health inequalities and we welcome comments on our conclusions.  

We will provide the necessary tools and resources to help stakeholders with their own impact assessments, including updated Technical Support Documents from the Decision Support Unit (DSU). People’s perceptions of health-related quality of life vary across cultures and are affected by demographic differences, meaning that value sets are country specific.  

Valuation studies for the EQ-5D-5L have been conducted in a number of countries, to provide data on how the country’s population values the different health states measured by the EQ-5D-5L. Several Health Technology Assessment (HTA) agencies have adopted their local EQ-5D-5L value set into their methodology, including Canada, France, the Netherlands, and Spain. These agencies either accept the use of the EQ-5D-5L value set in economic evaluations or mandate that it should be used. 

What difference will the new value set make to NICE recommendations? 

The new EQ-5D-5L value set will be used in our evaluations and will affect the calculations of cost effectiveness. To understand the potential impact of adopting the EQ-5D-5L value set NICE commissioned an impact assessment using a sample of 37 published technology appraisals (TAs).  

Using the sample of 37 TAs, cancer medicines became more cost effective with the EQ-5D-5L value set compared with the EQ-5D-3L value set. For non-cancer drugs, the impact was mixed. Non-cancer drugs which improved health-related quality of life but did not impact survival became less cost effective. For non-cancer drugs which improved both health-related quality of life and survival, the impact was unpredictable: some became more cost effective and some became less cost effective.   

It is important to note that these results are based on a small sample and it is not possible to fully predict what effect the EQ-5D-5L will have on future evaluations and NICE recommendations.   

Why will the new value set change the cost effectiveness of medicines? 

When comparing the new UK EQ-5D-5L value set with the old EQ-5D-3L value set, people are now less willing to give up years of their life to avoid being in poor health. This suggests that, relative to the 3L value set study, people now place more weight on length of life than on health-related quality of life. It is the balance between these 2 things which determines if any individual medicine or technology will be more or less cost effective when using the 5L value set. But the findings from comparing the 5L and 3L value sets reflect more than just updated societal preferences. They also reflect changes in the measure (moving from the 3-level version to the 5-level version of the EQ-5D questionnaire), and improvements in the methods for studying people’s preferences and for modelling that data. 

Will the new value set affect whether technologies will qualify for the severity modifier weighting? 

The impact of adopting the EQ-5D-5L value set on which treatments would qualify for the severity modifier is complicated and variable, but it does not appear to have a dramatic effect on the overall severity weightings applied to technology appraisal decisions.  

Will the new value set apply to evaluations that are already underway? 

No. The adoption of the EQ-5D-5L value set will only apply to topics which start their evaluation after the updated manuals are published. For technology appraisals this means after the invitation to participate is issued, for HealthTech it refers to the topic launch and for guidelines this refers to topic selection. This follows the process set out in the modular updates framework.  

Have HTA organisations in other countries adopted their national EQ-5D-5L value set?

People’s perceptions of health-related quality of life vary across cultures and are affected by demographic differences, meaning that value sets are country specific.

Valuation studies for the EQ-5D-5L have been conducted in a number of countries, to provide data on how the country’s population values the different health states measured by the EQ-5D-5L. Several Health Technology Assessment (HTA) agencies have adopted their local EQ-5D-5L value set into their methodology, including Canada, France, the Netherlands, and Spain. These agencies either accept the use of the EQ-5D-5L value set in economic evaluations or mandate that it should be used.

View the consultation. The closing date for comments is Wednesday 13 May, 2026.

Sophie Cooper, senior scientific adviser at NICE, explains more about EQ-5D-5L in her blog, 'Better data for better decisions.'