Impact of Anosmia Severity on Health Utility Values in Chronic Rhinosinusitis With Nasal Polyps: An Exploratory Analysis From the WAYPOINT Trial
Author(s)
Danny Gibson, MASc1, Sam Colman, MBios2, Agota Szende, PhD3, Santiago Zuluaga Sanchez, MSc4.
1Market Access and Pricing, AstraZeneca, Cambridge, United Kingdom, 2Market Access Consulting & HEOR, Fortrea, Sydney, Australia, 3Market Access Consulting & HEOR, Fortrea, Leeds, United Kingdom, 4Health Economics, Amgen, Uxbridge, United Kingdom.
1Market Access and Pricing, AstraZeneca, Cambridge, United Kingdom, 2Market Access Consulting & HEOR, Fortrea, Sydney, Australia, 3Market Access Consulting & HEOR, Fortrea, Leeds, United Kingdom, 4Health Economics, Amgen, Uxbridge, United Kingdom.
OBJECTIVES: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly prevalent and under-investigated condition with significant effects on quality of life (QoL). Olfactory dysfunction is one of the core symptoms, however, there is limited evidence on how the severity of smell loss affects health utilities in this population. This research aims to estimate health utility values by smell loss severity using data from the WAYPOINT (NCT04851964) study, a phase 3, randomized, double-blind, placebo-controlled trial of tezepelumab in patients with CRSwNP.
METHODS: Patients, pooled across placebo and tezepelumab arms, were categorized by their smell loss severity at weeks 4, 12, 24, 36, and 52 using three classification methods: the University of Pennsylvania Smell Identification Test (UPSIT), SNOT-22 item 12 (patient-reported severity of smell loss), and the loss of smell item in the Nasal Polyp Symptom Diary (NPSD). Mean utility, higher values indicating better QoL, for each instrument were calculated by severity collapsed by visit based on [a] EQ-5D-5L (3L crosswalk from EQ-5D-5L), [b] SF-6D (mapped from SF-36), [c] EQ-5D-3L (mapped from SNOT-22), and [d] EQ-5D-3L (mapped from SF-36), all derived from published algorithms.
RESULTS: Lower utility values were associated with increasing smell loss severity across all classifications. Under the UPSIT scale, [a] values (mean; standard deviation [SD]) declined from 0.88 [0.14] in normosmia to 0.81 [0.18] in anosmia; [b] from 0.75 [0.11] to 0.72 [0.11]; [c] from 0.74 [0.13] to 0.66 [0.17]; and [d] from 0.66 [0.08] to 0.62 [0.09], respectively. This trend was mirrored across SNOT-22 item 12 and NPSD smell severity classifications, where all four preference-based instruments similarly reflected decreasing utility values with greater olfactory impairment.
CONCLUSIONS: This research provides robust evidence, based on clinical and patient-reported anosmia measures, that olfactory dysfunction in CRSwNP is associated with reduction in health utility values, especially in its severe form.
METHODS: Patients, pooled across placebo and tezepelumab arms, were categorized by their smell loss severity at weeks 4, 12, 24, 36, and 52 using three classification methods: the University of Pennsylvania Smell Identification Test (UPSIT), SNOT-22 item 12 (patient-reported severity of smell loss), and the loss of smell item in the Nasal Polyp Symptom Diary (NPSD). Mean utility, higher values indicating better QoL, for each instrument were calculated by severity collapsed by visit based on [a] EQ-5D-5L (3L crosswalk from EQ-5D-5L), [b] SF-6D (mapped from SF-36), [c] EQ-5D-3L (mapped from SNOT-22), and [d] EQ-5D-3L (mapped from SF-36), all derived from published algorithms.
RESULTS: Lower utility values were associated with increasing smell loss severity across all classifications. Under the UPSIT scale, [a] values (mean; standard deviation [SD]) declined from 0.88 [0.14] in normosmia to 0.81 [0.18] in anosmia; [b] from 0.75 [0.11] to 0.72 [0.11]; [c] from 0.74 [0.13] to 0.66 [0.17]; and [d] from 0.66 [0.08] to 0.62 [0.09], respectively. This trend was mirrored across SNOT-22 item 12 and NPSD smell severity classifications, where all four preference-based instruments similarly reflected decreasing utility values with greater olfactory impairment.
CONCLUSIONS: This research provides robust evidence, based on clinical and patient-reported anosmia measures, that olfactory dysfunction in CRSwNP is associated with reduction in health utility values, especially in its severe form.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE525
Topic
Economic Evaluation
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)