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The European Journal of Health Economics
Published in: The European Journal of Health Economics 1/2014

Open Access 01-01-2014 | Original Paper

Health state utilities for skeletal-related events secondary to bone metastases

Authors: Louis S. Matza, Karen Chung, Kate Van Brunt, John E. Brazier, Ada Braun, Brooke Currie, Andrew Palsgrove, Evan Davies, Jean-Jacques Body

Published in: The European Journal of Health Economics | Issue 1/2014

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Abstract

Introduction

Patients with bone metastases often experience skeletal-related events (SREs). Although cost-utility models are used to examine treatments for metastatic cancer, limited information is available on utilities of SREs. The purpose of this study was to estimate the disutility of four SREs: spinal cord compression, pathological fracture, radiation to bone, and surgery performed to stabilize a bone.

Methods

General population participants from the UK and Canada completed time trade-off (TTO) interviews to assess the utility of health states drafted based on literature review, clinician interviews, and patient interviews. Respondents first rated a health state describing cancer with bone metastases. Then, the SREs were added to this health state.

Results

Interviews were completed with 187 participants (50.8 % male, 80.2 % white). Cancer with bone metastases without an SRE had a mean utility of 0.47 (SD = 0.43) on a standard utility scale (1 = full health, 0 = death). Of the SREs, spinal cord compression was associated with the greatest disutility (i.e., the utility decrease): −0.32 with paralysis and −0.22 without paralysis. Surgery had a disutility of −0.07. Leg, arm, and rib fractures had disutilities of −0.06, −0.04, and −0.03. Two weeks of daily radiation treatment had a disutility of −0.06, while two radiation appointments had the smallest impact on utility (−0.02).

Conclusion

All SREs were associated with statistically significant utility decreases, suggesting a perceived impact on quality of life beyond the impact of cancer with bone metastases. The resulting disutilities may be used in cost-utility models examining treatments to prevent SREs secondary to bone metastases.
Appendix
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Metadata
Title
Health state utilities for skeletal-related events secondary to bone metastases
Authors
Louis S. Matza
Karen Chung
Kate Van Brunt
John E. Brazier
Ada Braun
Brooke Currie
Andrew Palsgrove
Evan Davies
Jean-Jacques Body
Publication date
01-01-2014
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 1/2014
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-012-0443-2

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