Health state utilities for non small cell lung cancer

Abstract

BackgroundExisting reports of utility values for metastatic non-small cell lung cancer (NSCLC) vary quite widely and are not all suitable for use in submissions in the UK. The aim of this study was to elicit UK societal based utility values for different stages of NSCLC and different grade III-IV toxicities commonly associated with chemotherapy treatments. Toxicities included neutropenia, febrile neutropenia, fatigue, diarrhoea, nausea and vomiting, rash and hair loss.MethodsExisting health state descriptions of metastatic breast cancer were revised to make them suitable as descriptions of metastatic NSCLC patients on second-line treatment. The existing health states were used in cognitive debrief interviews with oncologists (n = 5) and oncology specialist nurses (n = 5). Changes were made as suggested by the clinical experts. The resulting health states (n = 17) were piloted and used in a societal based valuation study (n = 100). Participants rated half of the total health states in a standard gamble interview to derive health state utility scores. Data were analysed using a mixed model analysis.ResultsEach health state described the symptom burden of disease and impact on different levels of functioning (physical, emotional, sexual, and social). The disutility related to each disease state and toxicity was estimated and were combined to give health state values. All disease states and toxicities were independent significant predictors of utility (p < 0.001). Stable disease with no toxicity (our base state) had a utility value of 0.653. Utility scores ranged from 0.673 (responding disease with no toxicity) to 0.473 for progressive disease.ConclusionThis study reflects the value that society place on the avoidance of disease progression and severe toxicities in NSCLC.

The clinical effectiveness and cost-effectiveness of cetuximab (review of technology appraisal no. 176) and panitumumab (partial review of technology appraisal no. 240) for previously untreated metastatic colorectal cancer: a systematic review and economic evaluation

“…[135][136][137][138] All of these sources were UK-based studies, using EQ-5D vignettes, but none was conducted on a CRC population, and some studies reported on the EQ-5D visual analogue scale and some reported on the EQ-5D time trade-off scale. 99 for the bevacizumab plus FOLFIRI comparison).…”

Quality-Adjusted Survival Following Treatment of Malignant Pleural Effusions With Indwelling Pleural Catheters

“…16 The present fi ndings are consistent with those in the literature, which demonstrated that for non-small cell lung cancer, utilities for various health states for cancerrelated outcomes range from approximately 0.33 (end of life) to 0.70 (responding to therapy), with progressive disease being approximately 0.47 utiles. 17 We observed that utility did not improve much following IPC placement, whereas dyspnea did improve, suggesting that many determinants affect quality of life in patients with MPEs. Although dyspnea certainly is one of these, other factors related to the underlying malignancy are also pivotal.…”

Time-Series Modeling and Simulation for Comparative Cost-Effective Analysis in Cancer Chemotherapy: An Application to Platinum-Based Regimens for Advanced Non-small Cell Lung Cancer

“…Data We performed M&S using the data available from a clinical study report 16) and other reports [18][19][20][21][22][23] ; the basic data regarding the chemotherapy such as the dose regimens, the data for OS and TTF, and the data of the occurrence rates of AEs taken from the clinical study report 16) are summarized in Table 1, and the data for drugs against AEs, utility values, and medical treatment fees are summarized in Table 2. The model parameters for the survival function were estimated based on the data for OS and TTF.…”

“…3 is an incremental cost and the denominator is a QALY-gained. Values for the QOL were calculated based on the reported utility values 18) for each of the AEs (Table 2). In the present study, we defined the "base (responding disease with no toxicity)" value (0.6725) to be a sum of the values for "intercept (0.6532)" and "response (0.0193)."…”