Measurement of Utilities by Time to Death Related to Advanced Non-Small Cell Lung Cancer in South Korea

Abstract

A 3 4 7 -A 7 6 6 EQ-5D record. Mean utility score for patients in progression-free and progressive disease state is 0.76 (95% CI 0.75, 0.77) and 0.69 (95% CI 0.66, 0.71), respectively. Mean utility showed a decrease on disease progression of 0.07, which is considered as clinically meaningful. Patients were split into five groups based on their time to death after the EQ-5D questionnaire was taken -over 360 days, 180-360 days, 90-180 days, 30-90 days, and under 30 days, and mean utility in each timeto-death category is 0.81(95% CI 0.79, 0.83),0.73 (95% CI 0.71, 0.75),0.69(95% CI 0.66, 0.72),0.60 (95% CI 0.56, 0.64) and 0.40 (95% CI 0.31, 0.48).the results showed a large decrease in utility in the 30 days prior to death. ConClusions: The results showed that quality of life for pre-treated advanced NSCLC patients rapidly deteriorates during the end of life period. Considerable deterioration of utility in NSCLC patients is associated with disease progression and time to death. The utility values estimated from the study will inform economic evaluations of treatments in pre-treated advanced NSCLC. PCN200

Systematic review of health state utility values in metastatic non-small cell lung cancer with a focus on previously treated patients

“…Among the 36 articles (34 studies) identified, 19 reported EQ-5D scores [ 37 – 55 ] (three studies further specified the instrument as EQ-5D-3 L [ 39 , 41 , 56 ] and two as EQ-5D-5 L [ 44 , 57 ]; Table 2 ), two reported SG or TTO directly elicited from patients [ 58 , 59 ], two reported EQ-VAS scores only [ 57 , 60 ], and one reported AQoL scores [ 61 ] (Table 2 ). Moreover, one study reported SF-12 scores for caregivers to patients with mNSCLC [ 62 ], eight reported HSUVs from valuations of vignettes made by members of the public using SG or TTO [ 59 , 63 – 69 ] (one of which reported both general public-elicited SG and patient-elicited TTO) [ 59 ], and one reported disutility estimates based on expert opinion for pneumothorax, thrombocytopenia and thrombosis, adverse event health states for which disutilities were not available from other HSUV derivation methods [ 70 ]. A further two articles reported HSUVs but were unclear about how these were derived; one reported disutilities used in previous NICE submissions, for anaemia and for oral and intravenous treatment modes [ 71 ], and one reported a “global quality of life index” for second-line NSCLC [ 72 ].…”

“…Eleven studies focused exclusively on HSUVs associated with second-line treatment [ 41 , 45 , 48 – 51 , 57 , 59 , 69 , 71 , 72 ], and five reported HSUVs in second-line and subsequent treatment [ 37 , 40 , 56 , 60 , 73 ]. Line of treatment was unspecified in 15 studies [ 42 – 44 , 47 , 52 – 55 , 58 , 61 – 63 , 65 – 67 ].…”

What is the Impact of the Analysis Method Used for Health State Utility Values on QALYs in Oncology? A Simulation Study Comparing Progression-Based and Time-to-Death Approaches

“…A number of published economic evaluations of IO treatments have used the approach of TTD-based utility values, noting that such an approach avoids a number of issues typically attributed to progression-based analyses [5][6][7]. A recent review of IO appraisals performed by the National Institute for Health and Care Excellence (NICE) found that of the 21 identified company submissions, 11 defined health states by progression status, seven by TTD, and three by using a model that had aspects of both elements [8]; a per-appraisal summary is presented in the Online Supplementary Materials (OSM).…”