Utility and Work Productivity Data for Economic Evaluation of Breast Cancer Therapies in the Netherlands and Sweden

Abstract

ObjectiveThis study aims to estimate utility values in laypeople and productivity loss for women with breast cancer in Sweden and the Netherlands. Study DesignTo capture utilities, validated health state vignettes were used, which were translated into Dutch and Swedish. They described progressive disease, stable disease, and seven grade 3/4 adverse events. One hundred members of the general public in each country rated the states using the visual analog scale and Time Trade-Off methods. To assess productivity, women who had recently completed or were currently receiving treatment for early or advanced breast cancer (The Netherlands = 161 and Sweden = 52) completed the Work Productivity and Activity Impairment - General Health (WPAI-GH) questionnaire. Data were analyzed using means and standard deviations. ResultsThe utility study showed that the Swedish sample rated progressive and stable disease (0.61 [95% confidence interval ±0.07], 0.81 [±0.05]) higher than the Dutch sample (0.49 [±0.06], 0.69 [±0.05]). The health states incorporating the toxicities in both countries produced similar mean scores. Results of the WPAI-GH showed those currently receiving treatment reported productivity reductions of 69% (The Netherlands) and 72% (Sweden); those who had recently completed therapy reported reductions of 41% (The Netherlands) and 40% (Sweden). ConclusionThe differences in the utility scores between the countries underline the importance of capturing country-specific values. The significant impact of adverse events on health-related quality of life was also highlighted. The WPAI-GH results demonstrated how the negative impact of breast cancer on productivity persists after women have completed their treatment.