Recognising Normative Global Differences in Health Concept Structures: Developing a New Preference-Based Measures of Health in Asia

Author: Molly Paffett, with contributions from Francis Panlilio

11 Sep 2023 1770 0

Preference-based measures (PBMs) are used to determine the health state utility weights assigned to the life-year outcome of a particular health state. Quality-adjusted Life Years (QALYs) are the most common measure of health outcomes used in health economic evaluations and bring together the morbidity and mortality dimensions of health outcomes are bought together.


Many generic preference-based measures exist and are widely accepted within health technology assessments and economic evaluations. However, these have been developed in Western countries which may limit their generalisability to the Asian context where the structure of health concepts is different.


To address this gap, a team led by the Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Japan in collaboration with representatives of HTAsiaLink, has constructed a new region-specific PBM for East and Southeast Asian countries. Using local interviews in nine East and Southeast Asian countries to elicit concepts, published literature, and existing instruments, they constructed the Asia PBM 7 dimensions (AP-7D) to reflect the general public health context. The seven dimensions used in this measure are: pain, mental health, energy, mobility, work or school, interpersonal interactions, and burden to others. Compared to existing PBMs, these dimensions capture the structure of health concepts in Asia and provide a more relevant measurement of health-related quality-of-life in such settings. This measure can therefore be used to inform economic evaluations conducted in the region more suitably.


If you are interested in using this instrument in your context and would like to learn more about this study, please reach out to C2H at C2HCenter for Outcomes Research and Economic Evaluation for Health (


Link to the full article.