OBJECTIVES

: Utility values are used in cost-utility analysis, in which health benefits are usually measured in terms of quality-adjusted life-years. However, there is still a lack of reference data on utility values in the French oncologic population. The aim of this study was to estimate deterioration of utility over time and identify associated factors using prospective close to real-life data collection.

METHODS

This study was based on data from 2 prospective clinical trials, QOLIBRY and QUANARIE, assessing the ability of electronic assessment of HRQoL in routine practice. Included patients were treated for breast (BC), colorectal (CRC), lung cancer (LC) in the QOLIBRY cohort and advanced renal (RC) cancer in the QUANARIE cohort. Utility values were estimated using EuroQoL EQ-5D, evaluated since the start of treatment and at each consultation. Time to deterioration (TTD) was defined as the time from baseline to the occurrence of a first clinically significant deterioration of at least 0.08 points. TTD was calculated using interval-censored survival analysis. A proportional hazard model was used to identify independent factors associated with TTD.

RESULTS

: We analysed 235 patients. At baseline, average utility values were 0.782 (+/- 0.220) in BC, 0.776 (+/- 0.268) in CRC, 0.555 (+/- 0.357) in LC and 0.701 (+/- 0.298) in RC group. The median TTD were 73 days (95%CI, 28-111), 110 (27-NA), 55 (41-70) and 46 (15-80), respectively. 57% of patients experienced a deterioration, ranging from 45% in the CRC group to 63.5% in the RC group. The median follow-up were 112 days (105-116) in the QoLIBRY cohort and 199 days (175-238) in the QUANARIE cohort. None of the socio-demographic or clinical factors were significantly associated with TTD.

CONCLUSIONS

These results question the revelance of the EQ-5D, which may lack of sensitivity and specificity for health economic evaluation in oncology.