A Systematic Literature Review of Health Utility Values in Breast Cancer

Abstract

Background Health utility values (HUVs) are important inputs to the cost-utility analysis of breast cancer interventions. Purpose Provide a catalog of breast cancer–related published HUVs across different stages of breast cancer and treatment interventions. Data Sources Systematic searches of MEDLINE, MEDLINE In-Process, EMBASE, Web of Science, CINAHL, PsycINFO, EconLit, and Cochrane databases (2005–2017). Study Selection Studies published in English that reported mean or median HUVs using direct or indirect methods of utility elicitation for breast cancer. Data Extraction Independent reviewers extracted data on a preestablished and piloted form; disagreements were resolved through discussion. Data Analysis Mixed-effects meta-regression using restricted maximum likelihood modeling was conducted for intervention type, stage of breast cancer, and typical clinical and treatment trajectory of breast cancer patients to assess the effect of study characteristics (i.e., sample size, utility elicitation method, and respondent type) on HUVs. Data Synthesis Seventy-nine studies were included in the review. Most articles ( n = 52, 66%) derived HUVs using the EQ-5D. Patients with advanced-stage breast cancer (range, 0.08 to 0.82) reported lower HUVs as compared with patients with early-stage breast cancer (range, 0.58 to 0.99). The meta-regression analysis found that undergoing chemotherapy and surgery and radiation, being diagnosed with an advanced stage of breast cancer, and recurrent cancer were associated with lower HUVs. The members of the general public reported lower HUVs as compared with patients. Limitations There was considerable heterogeneity in the study population, health states assessed, and utility elicitation methods. Conclusion This review provides a catalog of published HUVs related to breast cancer. The substantial heterogeneity in the health utility studies makes it challenging for researchers to choose which HUVs to use in cost-utility analyses for breast cancer interventions.

The impact of age on health utility values for older women with early-stage breast cancer: a systematic review and meta-regression

“…(2010) [ 12 ] and Kaur et al . (2022) [ 13 ]). Our study quantified the association between HSUVs and age by controlling for similar variables.…”

“…CRD42021232743). After registration, a minor revision was made to only include studies that measured HSUVs by an EQ-5D instrument only, to avoid duplication with another systematic review by Kaur et al published in 2022 [ 13 ]. EQ-5D is the generic multi-attribute measure of health status used most often by health technology assessment bodies around the world.…”

“…‘Surgery’ comprised different types of surgical intervention (for example, mastectomy or breast conserving surgery) to reduce the number of independent variables in the meta-regression, following the approach by Kaur et al . [ 13 ].…”

“…Similarly, Kaur et al . (2022) [ 13 ] report a meta-regression of health utility values across different stages of breast cancer and treatment. Both studies demonstrate the value of meta-regression to establish whether patient-level and treatment-related variables are associated with mean HSUVs.…”

Health utility values of breast cancer treatments and the impact of varying quality of life assumptions on cost‐effectiveness

“…However, utility scores on comparable health states have been found to vary between studies. [13][14][15][16][17] The differences between these estimates can largely be explained by three issues.…”