Health Utilities Using the EQ-5D in Studies of Cancer

Abstract

Cancer is one of the most frequent disease-specific applications of the EQ-5D. The objective of this review was to summarise evidence to support the validity and reliability of the EQ-5D in cancer, and to provide a catalogue of utility scores based on the use of the EQ-5D in clinical trials and in studies of patients with cancer. A structured literature search was conducted in EMBASE and MEDLINE to identify papers using key words related to cancer and the EQ-5D. Original research studies of patients with cancer that reported EQ-5D psychometric properties, responses and/or summary scores were included. Of 57 identified articles, 34 were selected for inclusion, where 12 studies reported evidence of validity or reliability and 31 reported EQ-5D responses or summary scores. The majority of investigations using the EQ-5D concerned patients with prostate cancer (n = 4), breast cancer (n = 4), cancers of the digestive system (n = 7) and Hodgkin and/or non-Hodgkin lymphoma (n = 3). Mean index-based scores ranged from 0.33 (SD 0.4) to 0.93 (SD 0.12) and visual analogue scale scores ranged from 43 (SD 13.3) to 84 (SD 12.0) across subtypes of cancer. A substantial and growing body of literature using the EQ-5D in cancer that supports the validity and reliability of EQ-5D in cancer has emerged. This review provides utility estimates for cancer patients across a wide range of cancer subtypes, treatment regimens and tumour stage(s) that may inform the modelling of outcomes in economic evaluations of cancer treatment.

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

“…An improvement across time was recorded to the reported health states both at the completion of chemotherapy and at the 6-month follow-up time point. This is consistent with findings from other prospective studies [25,26], where even though deterioration in quality of life following administration of chemotherapy was reported, a quick rebounding effect was observed. The improvement of reported health states observed in our study was not different between treatment arms.…”

Societal preference values for advanced melanoma health states in the United Kingdom and Australia

“…Relative to UK respondents, Australians reported a lower impact of the less-severe clinical response states and a greater impact of the more-severe response states. Similarly, studies using indirect methods, such as the EQ-5D, to estimate patient preferences have shown quite large intercountry differences, including in patients with cancer (Sullivan et al, 2005;Pickard et al, 2007). The higher mean utility for partial response in Australia relative to that in the United Kingdom translated into toxicities being valued less favourably by Australian respondents when considered as toxicity-specific utility decrements.…”

Cost-Effectiveness of Systemic Therapies for Metastatic Pancreatic Cancer

“…The surveys contained various clinical scenarios involving metastatic pancreatic cancer patients undergoing chemotherapy with or without side effects (Appendix b). The medical oncologists were asked to rate the health utilities of the patients in the scenarios using the EQ-5D measure 13 . Questions from the EQ-5D covered mobility, self-care, usual activities (for example, work, study, housework, and family or leisure activities), pain and discomfort, and anxiety and depression.…”