Valuing Health States in Russia: A First Feasibility Study

The aim of this study was to explore the feasibility of different health-related quality-of-life valuation methods in a new setting. Based on a small feasibility study of 100 young Russians, we trialed different methodologies and identified key differences that have implications for the development of health technology assessment in Russia.

In face-to-face interviews, respondents completed a series of health self-assessments based on a modified version of the EQ-5D-3L, visual analogue scale, time tradeoff, standard gamble, and best-worst scaling methodologies, covering actual and hypothetical health states.

We found that (1) the visual analogue scale produced lower health valuations and fewer logical inconsistencies than either time trade-off or standard gamble methodologies; (2) initial health states can be decisive in determining values assigned to health improvements; (3) respondents evaluate abstract health states more positively than their own actual health states; (4) there is evidence consistent with the hypothesis that actual and hypothetical health state valuation, using EQ-5D-3L, is an artifact of understanding rather than preference and that the incorporation of additional levels may therefore be no panacea if the dimensions themselves overlook important attributes; and (5) the country context is important in determining how respondents relate to the survey tools and how those survey tools are translated and delivered.

Russia is commencing its health technology assessment journey and should proceed cautiously as it moves toward the valuation of health benefits. These results suggest a useful framework for a more in-depth development of health valuation methodologies in Russia.