OBJECTIVES: To measure the quality of life and estimate health state utility values (HSUV) in patients with end-stage cancer disease in Poland.

METHODS: Cancer patients of four hospices (Gdansk, Gdynia, Puck, Sopot) were asked to fill in the paper-and-pencil version of the EQ-5D-5L questionnaire. Polish EQ-5D-5L value sets [(1) directly measured, TTO/DCE-based; (2) indirect, based on cross-walk methodology] were used to estimate HSUVs. Patients results were compared to Polish general population normative data (published in 2017).

RESULTS: Seventy-four patients (64% females), mean age 73 years (SD 11.6; range 42-95), with 18 different kinds of cancer and mean time 3.4 (SD 3.6) years from diagnosis, took part in the survey. Patients presented 61 different health states, with median severity index (sum of dimensions’ levels, range 5 – no problems to 25 – extreme problems in all dimensions) 18 (Q1 – Q3: 14 - 21). Severe or extreme problems were common: 68.9%, 67.6%, 59.5%, 41.9% and 32.4% within mobility, usual activities, self-care, pain/discomfort and anxiety/depression dimensions, respectively. Only 1.4%, 6.8% and 8.1% patients presented with no problems within usual activities, mobility and self-care dimensions. Mean subjective health rating using visual analogue scale (VAS) - 52.0 (21.0) was 8.0 (SD 19.9) lower than in Polish general population. Mean HSUV measured with a direct value set: 0.360 (0.407) was higher than HSUV measured with a cross-walk value set 0.338 (0.378), but also presented with a greater range: -0.466 to 0.96 compared to -0.431 to 0.905. Mean HSUV based on cross-walk value set was 0.450 (0.368) lower than population norm according to age and gender.

CONCLUSIONS: Patients with end-stage cancer constitute a disabled population, with severe limitations within the quality of life dimensions. A set of health state utility values was estimated to be used in economic evaluations of cancer-oriented interventions.