Derivation of Utility Values from European Organization for Research and Treatment of Cancer Quality of Life-Core 30 Questionnaire Values in Lung Cancer

Evaluation of content on EQ-5D as compared to disease-specific utility measures

PURPOSE

The goal of this study was to appraise the extent of unique content on disease-specific preference-based measures (DSPMs) when contrasted with the EQ-5D using published studies and to inform whether EQ-5D could be inadequate as a utility measure in its content coverage for a given disease-specific application.

METHODS

A structured search of published literature was performed using PubMed and EMBASE/Medline database from Jan 1, 1990 to Mar 31, 2011. Articles were eligible for inclusion if algorithms were developed to convert components from disease-specific measures into utility scores.

RESULTS

Of 1,029 articles identified, 50 studies satisfied the inclusion criteria. The most frequent conditions where DSPMs were developed included cancer (12 studies), coronary artery disease (4 studies), osteoarthritis, rheumatoid arthritis (3 studies of each), obesity, and stroke (2 studies of each). Most studies involved mapping items or scores from disease-specific non-preference-based measures onto a preference-based measure of health such as the EQ-5D. A substantial number of DSPMs appeared to include unique content not covered by EQ-5D dimensions.

CONCLUSIONS

Several conditions were identified as potential areas where the richness of the EQ-5D descriptive system could be enhanced. It is yet unclear whether added dimension(s) would contribute unique explained variance to a utility score. Given the resources required to rigorously develop a utility measure, the need for such measures should be carefully vetted.

Costs and ethical issues related to first-line treatment of metastatic non-small-cell lung cancer: considerations from a public healthcare system perspective

Metastatic non-small-cell lung cancer is generally not considered to be curable, and the overall 5-year survival rate is less than 1%. Despite this poor prognosis, palliative chemotherapy can increase time and quality of life in the advanced-disease setting. New chemotherapy treatments and targeted therapies are available for this stage of disease, but their high costs are an important issue. In this perspective article, we discuss the hospital costs of antitumor drug administration and the ethical principles involved, the roles of drug agencies and oncologists, and relevant current research on these topics. These considerations have been examined from the perspective of a national public healthcare system.