Health state utilities for metastatic breast cancer in Taiwan

Abstract

Background New developments in medications for metastatic breast cancer (MBC) can be of great benefit to patients, but unfortunately these medicines also increase expenditures. Cost-utility analyses (CUAs) are needed to allocate health resources properly, and health utility values are required to calculate quality-adjusted life years in those CUAs. Objective The aims of this study were to measure health utility values for several MBC-related health states and certain breast cancer treatment-related grade 3/4 adverse drug reactions (ADRs). In addition, we examined whether different methods and respondents’ characteristics would influence the utility values elicited. Methods A cross-sectional survey was conducted. The visual analogue scale (VAS) and time trade-off (TTO) methods were used to measure health utilities. Four MBC and nine ADR health states were selected for evaluation based on literature review and expert opinion. Information about respondents’ demographic and clinical characteristics were collected to examine the relationship between utilities and participant characteristics. Results A total of 102 patients participated in this study. The TTO-elicited values were higher than the VAS-derived scores except for two MBC-related health states. Among the MBC health states assessed, the TTO preference score ranged from 0.04 (palliative MBC) to 0.62 (responding MBC). For grade 3/4 ADRs, the mean TTO-derived utility values ranged from 0.35 (nausea/vomiting) to 0.79 (fatigue). The ranking of the preference scores derived from the VAS was similar to that of the TTO-elicited scores. Conclusion This study obtained health state utility values for MBC and grade 3/4 ADRs using both the TTO and the VAS, which provides useful data for future CUAs.

Cost‐effectiveness analysis of trastuzumab emtansine (T‐DM1) in treating HER‐2 positive advanced breast cancer in Taiwan

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Validation of the predictive accuracy of health-state utility values based on the Lloyd model for metastatic or recurrent breast cancer in Japan

“…The range of variability they report for these HSUVs is comparable to the fixed error found in our study. Tachi et al 15 and Chou et al 23 also reported that adverse events during chemotherapy were associated with lower HSUVs, as did Lloyd et al 9 Second, the guidelines for conducting cost-effectiveness analyses in Japan’s healthcare sector recommend that sensitivity analysis be conducted. Cost-effectiveness analysis involves uncertainty in the analytical framework and the data itself.…”

Trastuzumab deruxtecan versus trastuzumab emtansine for patients with human epidermal growth factor receptor 2-positive metastatic breast cancer: A cost-effectiveness analysis

“…Furthermore, based on published research and China's GDP (gross domestic product), the WTP thresholds were determined to be $150,000/QALY and $37,653/QALY (3 times China's GDP per capita in 2021) to evaluate the cost-effectiveness of the US and China [ 22 , 23 ]. Since no health utility was reported in clinical trials, the average health utility for PFS and PD status was assumed to be 0.70 and 0.50, respectively, using previously published articles [ 20 , 24 , 25 ]. We also corrected for mean health utility by disutility due to grade 3/4 AEs [ 20 , 22 , 26 , 27 ]( Table 1 ).…”