OBJECTIVES

: In recent years, a hotly debated topic has been the application of condition-specific utilities versus generic utilities for health technology assessment. The European Organization for the Research and Treatment of Cancer 30-item Core Quality of Life Questionnaire (QLQ-C30) is a widely used cancer-specific health profile. With the development of the Quality of Life Utility measure-Core 10 Dimensions (QLQ-C10D), data collected using the QLQ-C30 can be used to generate utilities to inform cost-effectiveness analyses (CEAs). This study aimed to assess the implications of using utilities based on the QLU-C10D versus the 3-level EQ-5D (EQ-5D-3L) for assessing the cost effectiveness of immuno-oncologic agents for treating metastatic melanoma.

METHODS

: Quality of life from a clinical study CheckMate066 where both QLQ-C30 and EQ-5D-3L (Australian weights) was observed the basis of this study. The potential influence of the two instruments on cost effectiveness was assessed using a 3-state (progression-free, progression, dead) published model using an Australian societal perspective. Descriptive statistics and standard CEA outputs, such as acceptability curves, were used to examine differences between the utility measures.

RESULTS

: Results

Mean baseline utility values as measured by the QLU-C10D (mean=0.744, SD=0.219) were not statistically different (p=0.032) when compared to the EQ-5D (mean=0.735, SD=0.239). The model predicted a slightly higher number of quality-adjusted life years (QALYs) when applying EQ-5D instead of QLU-C10D utilities (1.87 vs. 1.74, respectively). This resulted in an incremental cost-effectiveness ratio of AU$39.1K when using EQ-5D utilities as opposed to AU$41.9K when using QLU-C10D utilities. Acceptability curves based on the two sets of utilities were almost indistinguishable.

CONCLUSIONS

: The results of this study demonstrate that the disease specific utility represented by QLU-C10D yielded similar results as EQ-5D which is consistent with emerging findings from independent investigations.