Health State Utility Values By Time to Death in Recurrent or Metastatic Squamous-Cell Carcinoma of the Head and Neck
Author(s)
Noon K1, Trigg A2, DeRosa M3, Singh P4, Bennett B1, Taylor F5, Cocks K2
1Bristol Myers Squibb Pharmaceuticals Ltd, Uxbridge, UK, 2Adelphi Values Ltd, Bollington, UK, 3Adelphi Values, Boston, MA, USA, 4Bristol Myers Squibb, Lawrenceville, NJ, USA, 5Adelphi Values LLC, Boston, MA, USA
OBJECTIVES: Cost-utility analysis is the preferred form of economic evaluation for the majority of reimbursement agencies. This analysis aimed to estimate utilities based on time-to-death (TTD) periods associated with recurrent or metastatic squamous-cell carcinoma of the head and neck (SCCHN). METHODS: Utilities were generated using patient-level data of the CheckMate 141 trial (NCT02105636; December 2015 data cut) of nivolumab versus investigator’s choice using the three-level EQ-5D (EQ-5D-3L) and UK value set. TTD periods were defined in line with prior approaches to TTD-based utility values and modified based on data availability (Model 1: ≥183 days, 92-182 days, 0-91 days; Model 2: 57-91 days, 29-56 days, 0-28 days). Utility values were estimated using linear mixed models with a fixed effect of TTD period and random intercept for each patient. Treatment-independent and treatment-specific (incorporating fixed effects of treatment and its interaction with TTD period) utilities were estimated. RESULTS: 502 observations from 273 patients could be assigned to a TTD period. Estimated treatment-independent utilities were: ≥183 days (n=135, 0.694 [95% CI 0.652, 0.736]), 92-182 days (n=81, 0.651 [95% CI 0.594, 0.707]), 0-91 days (n=118, 0.510 [95% CI 0.461, 0.560]). Splitting the final 3 months prior to death yielded the following utilities: 57-91 days (n=63, 0.569 [95% CI 0.484, 0.655]), 29-56 days (n=40, 0.487 [95% CI 0.378, 0.596]), 0-28 days (n=33, 0.422 [95% CI 0.302, 0.541]). Treatment-specific utilities showed a similar trend of decreasing utilities closer to death in a near-linear fashion; however, sample sizes became small for the final TTD periods. CONCLUSIONS: This study estimated TTD-based utility values in SCCHN. Utility values decreased in a monotonic trend in accordance with closer TTD, especially in the final 3 months prior to death. These values can support cost-utility analyses as a supplementary alternative to the more commonly applied progression-based models.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PCN295
Topic
Economic Evaluation, Patient-Centered Research
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Health State Utilities
Disease
Oncology