Quo Vadis Hyt: A Comparison of Hyt and Qalys in HER2+ Breast Cancer
Author(s)
Bührer C1, Jovanoski N2, Aponte Ribero V3, Ray J1
1F. Hoffmann-La Roche, Basel, BS, Switzerland, 2F. Hoffmann-La Roche, Basel, LON, Switzerland, 3F. Hoffmann-La Roche Ltd, Basel, LON, Switzerland
Presentation Documents
OBJECTIVES: Although a foundation for health economic evaluations, the shortcomings of the quality-adjusted life year (QALY) are well documented. Health Years in Total (HYT) have recently been proposed as an alternative metric to avoid the QALY’s discriminatory characteristic against patients with lower quality of life. This research aims to assess the impact of incorporating HYT in two cancer settings. METHODS: Two published health economic models comparing treatment with Trastuzumab-emtansine (TDM1) to the current standards of care in adjuvant and metastatic HER2+ breast cancer were adapted. The models were modified to also include the HYT metric. Differences between QALYs and HYT were compared, including sensitivity analyses varying the baseline age of patients and utility values. RESULTS: In the adjuvant setting TDM1 was estimated to result in an increase of 2.57 QALYs and 2.73 HYT compared to Trastuzumab. In the metastatic setting, improvements attributed to TDM1 treatment ranged from 0.54 to 0.9 QALYs and 0.84 to 1.39 HYT depending on the comparator. In both settings, the ranking of which treatment provided the largest number of HYT remained consistent with the QALY calculation. Additional analysis suggested that HYT were less sensitive to utility inputs. Clinical outcomes remained proportional in both models when patients’ baseline age was varied. CONCLUSIONS: The results indicate that using HYT rather than QALYs would not have changed the decision as to which treatments deliver the most clinical gains. Further analyses should seek to reassess the impact of the variations in the HYT metric versus the QALY in disease areas where treatment efficacy is less influenced by mortality gains.
Conference/Value in Health Info
2021-11, ISPOR Europe 2021, Copenhagen, Denmark
Value in Health, Volume 24, Issue 12, S2 (December 2021)
Code
POSB304
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Novel & Social Elements of Value, Thresholds & Opportunity Cost, Value Frameworks & Dossier Format
Disease
Oncology