OBJECTIVES: HTA guidelines often recommend local/country-specific value sets for preference-based measures of health. International harmonization of value set protocols have facilitated comparison of cultural attitudes related to health dimensions. This study examines the potential of a single value set in culturally similar countries.

METHODS: Value sets from the US, Canada, and Australia for the FACT-8D were compared using ranking of coefficients and empirically with secondary cross-sectional data from 534 participants with cancer. ANOVA was used to compare the discriminative ability of the FACT-8D scores across Eastern Cooperative Oncology Group (ECOG) performance status groups (assessed by both physicians and patients). Relative efficiency (RE) ratios were calculated to compare the discriminative power of the Canadian and Australian value sets relative to the US value set. Pearson correlation coefficients were used to evaluate associations between the FACT-8D utility scores and ECOG performance status groups for each country.

RESULTS: US, Canadian, and Australian value sets revealed similarities in the distribution and trends of scores across ECOG performance status groups. The RE ratios of the FACT-8D scores in discriminating functional status based on the ECOG measure were comparable among the three country value sets, with Canada (F=27.1, RE=1.1) and Australia (F=24.4, RE=0.96) showing similar REs to the US (F=25.5). The correlation between utility scores and ECOG group was consistent across the three countries. These findings were also observed when using patient-reported ECOG status.

CONCLUSIONS: Utility scores from the three country value sets showed comparable statistical efficiency and the same order of importance in the 8 dimensions, regardless of the range of scale among the total sample and each ECOG score subgroup. The results suggest these countries are culturally similar in terms of attitudes towards health in cancer, which could justify the potential for a single value set in cancer diagnosis among countries with culturally similar characteristics.