Health State Utilities of Advanced Melanoma Patients Treated in Clinical Practice in the Era of Novel Immuno- and Targeted Therapies

Author(s)

Franken M1, de Groot S2, van Dongen A3, Leeneman B3, Uyl-De Groot C1, Aarts MJB4, van den Berkmortel FWPJ5, Blank CU6, Boers-Sonderen MJ7, van den Eertwegh AJM8, de Groot JWB9, Haanen JBAG6, Hospers GAP10, Kapiteijn E11, van Not OJ12, Piersma D13, van Rijn RS14, Stevense-den Boer MAM15, Suijkerbuijk KPM16, van der Veldt AAM17, Vreugdenhil G18, Wouters MWJM6, Versteegh M19, Blommestein HM3
1Institute for Medical Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands, 2Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, ZH, Netherlands, 3Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands, 4Maastricht University Medical Center, Maastricht, Netherlands, 5Zuyderland Medical Center, Sittard-Geleen, Netherlands, 6Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, Netherlands, 7Radboud University Medical Center, Nijmegen, Netherlands, 8Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, Netherlands, 9Isala, Zwolle, Netherlands, 10University Medical Center Groningen, Groningen, Netherlands, 11Leiden University Medical Center, Leiden, Netherlands, 12Dutch Institute for Clinical Auditing, Leiden, Netherlands, 13Medisch Spectrum Twente, Enschede, Netherlands, 14Medical Center Leeuwarden, Leeuwarden, Netherlands, 15Amphia Hospital, Breda, Netherlands, 16University Medical Center Utrecht Cancer Center, Utrecht, Netherlands, 17Erasmus MC Cancer Institute, Rotterdam, Netherlands, 18Maxima Medical Center, Eindhoven, Netherlands, 19Institute for Medical Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, ZH, Netherlands

Presentation Documents

OBJECTIVES : To account for the impact of treatment on health-related quality of life (HRQoL), health economic models require insights into changes in HRQoL during the disease course. We estimated health state utilities of advanced (unresectable stage IIIc/IV) melanoma patients treated with systemic treatment in clinical practice in the era of novel immuno- and targeted therapies.

METHODS : Data were retrieved from the nation-wide Dutch Melanoma Treatment Registry of patients who received systemic treatment in clinical practice (data cut-off May 2020). Patients either completed the EQ-5D-3L (included 2014 to mid-2016) or the EQ-5D-5L (included from mid-2016). EQ-5D-5L utilities were estimated using the Dutch value set. EQ-5D-3L scores were mapped to EQ-5D-5L utilities using the eq5dmap command in STATA. Using a random-effects model to account for panel data, we estimated utilities for seven health states including three progression-free (PF1-PF3) and three progressive disease (PD1-PD3) health states and one health state after the third progression (HS7) to assess HRQoL in subsequent treatment lines.

RESULTS : A total of 182 and 356 patients completed 528 and 1263 EQ-5D-3L and EQ-5D-5L questionnaires, respectively. Patients were on average 61 years and 59% was male. Of all patients, 54% had a good prognosis, 20% an intermediate prognosis and 27% a poor prognosis. Quality of life was higher in progression-free periods (good prognosis PF1: 0.843 [95%CI:0.823-0.863]; PF2: 0.823 [95%CI:0.799-0.846]; PF3: 0.812 [95%CI:0.778-0.845]) compared to progressive disease periods (good prognosis PD1: 0.785 [95%CI:0.753-0.818]; PD2:0.780 [95%CI:0.737-0.823]; PD3: 0.784 [95%CI:0.718-0.851]; HS7: 0.774 [95%CI:0.720-0.828]). Compared to patients with a good prognosis, patients with an intermediate (-0.021 [95%CI:-0.057-0.016]) and poor (-0.073 [95%CI:-0.106- -0.039]) prognosis had lower health state utilities.

CONCLUSIONS : Health state utilities of patients with advanced melanoma treated with systemic treatment in clinical practice are better in patients with a good prognosis. Irrespective of prognosis, quality of life is higher during progression-free periods compared to progressive disease periods.

Conference/Value in Health Info

2021-11, ISPOR Europe 2021, Copenhagen, Denmark

Value in Health, Volume 24, Issue 12, S2 (December 2021)

Code

POSC365

Topic

Patient-Centered Research

Topic Subcategory

Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes

Disease

Oncology

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