PCN124 Health Utilities for Patients with HR-Positive, HER2-Negative EARLY Breast Cancer: A Systematic Literature Review

Abstract

To conduct a systematic literature review of health utility values associated with health states for patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer. A systematic literature review was conducted in accordance with PRISMA guidelines to identify health utilities for adult patients diagnosed with stage I-III HR+/HER2- breast cancer. Ovid MEDLINE, Embase, and National Health Service Economic Evaluations databases were searched between 2005 to 2019. Publications reporting health utilities for various health states, including treatment initiation, disease-free, and recurrence were included. Reference sources for cost-effectiveness model inputs were assessed for generalizability to HR+/HER2- early-stage disease. Of 3,622 records screened for eligibility, 19 studies (published between 2008 and 2019) reported health utility values. All studies were cost-effectiveness analyses (CEAs). A range of health utilities were reported for different health states: initiation of endocrine treatment (7 studies; 0.744 to 0.824) and chemotherapy (8 studies; 0.620 to 0.940), disease-free (15 studies; 0.779 to 0.980), and locoregional (1 study; 0.680) and distant recurrence (11 studies; 0.490 to 0.840). None of the model input source references specified a breast cancer subtype and were typically conducted in general breast cancer populations. Health utilities in HR+/HER2- patients differ throughout the patient treatment pathway according to disease status, treatment modality, and related toxicities. This study found that health utilities for disease-free health states were highest, whereas health utilities reported for recurrence, particularly metastatic events, were among the lowest. Current evidence indicates that available health utilities for patients with HR+/HER2- early breast cancer are limited to inputs in CEA studies; there is a clear need for utility values specifically obtained from patients with HR+/HER2- early breast cancer.