ASSESSING UTILITY VALUES FOR TREATMENT-RELATED HEALTH STATES OF ACUTE MYELOID LEUKEMIA IN THE UNITED STATES
Author(s)
Stein EM1, Yang M2, Gao W2, Galebach P2, Xiang CQ2, Bhattacharyya S3, Bonifacio G4, Joseph GJ4
1Memorial Sloan Kettering Cancer Center, New York, NY, USA, 2Analysis Group, Inc., Boston, MA, USA, 3Novartis Healthcare Pvt. Ltd., Hyderabad, India, 4Novartis Pharmaceuticals, East Hanover, NJ, USA
OBJECTIVES: Preference valuations of health status are essential in health technology and economic appraisal. This study estimated utilities for treatment-related health states of acute myeloid leukemia (AML) and dis-utilities of severe adverse events (SAEs) using a sample of individuals representative of the adult general population of the United States. METHODS: Applying the discrete choice experiment (DCE) methodology, an online survey was designed to capture the preference responses for pairs of health status scenarios including treatment-related AML health states and key grade 3/4 AEs of chemotherapies. Treatment-related AML health states, developed based on literature review and interviews with clinicians, included complete remission (CR), no CR, relapse, stem cell transplant (SCT), and post SCT short-term recovery. Six attributes, including fever, lack of energy, problems with daily function, anxiety/depression, blood transfusions, and hospitalization, each with 2 to 4 varying levels were used to define health states. Coefficients from conditional logistic regression model with generalized estimating equations were used to generate utilities of the predefined health states and dis-utilities of SAEs. RESULTS: 300 respondents completed the survey. The distribution of respondent demographics (age, race, gender, region, and income) was within a 3% margin of the distribution reported in the 2010 US Census data. CR had the highest utility value (0.875), followed by post SCT short-term recovery (0.398), relapse (0.355), no CR (0.262), and SCT (0.158). Of the key AEs, serious infection leads to the highest decline in utility by 0.218, followed by severe diarrhea (0.176), abnormally low blood cell counts (0.100), and redness/skin peeling (0.060). CONCLUSIONS: AML and treatments can be associated with a reduced quality of life and impaired ability to perform daily activities. The level of impairment depends on health status, including SAEs experienced during treatment. Findings from this study supported DCE methodology as a valid approach to obtain societal preference values for treatment-related health states.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PSY81
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities
Disease
Systemic Disorders/Conditions