ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2026
Quality-adjusted life expectancy norms for the Canadian population using EQ-5D-5L and SF-6Dv2.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundQuality-adjusted life expectancy (QALE) provides a comprehensive measure of population health. Despite its value, QALE norms are not available for the Canadian population. This study aimed to develop age- and sex-specific QALE norms using both the 5-level version of EQ-5D (EQ-5D-5L) and version 2 of SF-6D (SF-6Dv2) instruments.
methodsEQ-5D-5L and SF-6Dv2 data from 3,844 individuals in a national survey (2024) were used to derive health utility scores. These scores were then combined with official life tables from the Office for National Statistics (2021–2023) using the Sullivan method to calculate age- and sex-specific QALE. Estimates were produced for both undiscounted and discounted values (1.5%, 3.5%, and 5.0%). Uncertainty was quantified using a Monte Carlo simulation with 10,000 replications.
resultsAcross all ages, EQ-5D-5L utility scores were consistently higher than SF-6Dv2 scores. Women had higher life expectancy (LE) than men across all ages. Undiscounted QALE and QALE at a 1.5% discount rate based on EQ-5D-5L were higher for women, whereas at 3.5% and 5% discount rates they became lower than those of men. In contrast, both undiscounted and discounted QALE based on SF-6Dv2 were consistently higher for men than for women. Overall, SF-6Dv2 produced systematically lower QALE values than EQ-5D-5L. The disparity between LE and QALE was more pronounced in women, highlighting the impact of age-related morbidity.
conclusionsThese results provide the first Canadian QALE norms using both EQ-5D-5L and SF-6Dv2. QALE norms can inform health policy, resource allocation, and equity-sensitive assessments of healthcare interventions in Canada.
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