Abstract
PurposeTo capture UK societal health utility values for high-risk metastatic hormone-sensitive prostate cancer (mHSPC) and the disutility associated with treatment-related adverse events (AEs) to inform future cost–utility analyses.MethodsA literature review, and patient and clinical expert interviews informed the development of health states characterising mHSPC symptoms and the impact of treatment-related AEs on health-related quality of life (HRQL). Three base health states were developed describing a typical patient with high-risk mHSPC: receiving androgen deprivation therapy (ADT) [Base State 1]; receiving docetaxel plus ADT [Base State 2]; completed docetaxel and still receiving ADT whose disease has not yet progressed [Base State 3]. Six additional health states described treatment-related AEs. The health states were validated with experts and piloted with general public participants. Health state utilities were obtained using the time trade-off (TTO) method with 200 members of the UK general population. A generalised estimating equation (GEE) model was used to estimate disutility weights.ResultsMean TTO scores for Base State 1 to 3 were 0.71 (SD = 0.26), 0.64 (SD = 0.27), and 0.68 (SD = 0.26), respectively, indicating that receiving docetaxel plus ADT was most impactful on HRQL. The GEE model indicated when compared to Base State 2 that the nausea and vomiting AE had the most impact on HRQL (− 0.21), while alopecia was least burdensome (− 0.04).ConclusionsThe study highlights the differences in utility between base health states and the significant impact of treatment-related AEs on the HRQL of patients with mHSPC. These findings underline the importance of accounting for impaired HRQL when assessing treatments for mHSPC.
Highlights
Prostate cancer is the most common male cancer in the UK with over 47,000 men diagnosed every year [1]
The aim of this study was to capture societal-based utility values for health states related to metastatic hormone-sensitive prostate cancer (mHSPC) and disutility values for adverse events (AEs) associated with active treatment which could be used as inputs to cost–utility analyses
The searches resulted in the identification of three articles which examined patients with mHSPC treated with androgen deprivation therapy (ADT) [4, 6, 7], and five studies which evaluated patients with mHSPC treated with docetaxel [4, 13, 14, 16, 17]
Summary
Prostate cancer is the most common male cancer in the UK with over 47,000 men diagnosed every year [1]. It typically affects older men, aged between 65 and 79 years, approximately a quarter of all cases affect men under the age of 65 [2]. Men who present with metastases at initial diagnosis of prostate cancer are classified as having newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC), which currently accounts for approximately 18% of cases in the UK [1]. Symptoms of metastatic prostate cancer commonly include bone pain, fatigue, and urinary complications, as well as the psychological effects associated with both the impact of diagnosis and, later, disease progression [4]. The burden of disease and the potential impact of treatment mean that men with mHSPC often experience an impaired health-related quality of life (HRQL) [4]
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