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. 2017 Oct 17;17(1):689.
doi: 10.1186/s12885-017-3673-y.

Societal preferences for adjuvant melanoma health states: UK and Australia

Mark R Middleton  1 , Michael B Atkins  2 , Kaitlan Amos  3 , Peter Feng Wang  4 , Srividya Kotapati  4 , Javier Sabater  5 , Kathleen Beusterien  6
Affiliations

Societal preferences for adjuvant melanoma health states: UK and Australia

Mark R Middleton et al. BMC Cancer. .

Abstract

Background: No studies have measured preference-based utility weights for specific toxicities and outcomes associated with approved and investigational adjuvant treatments for patients with resected high-risk melanoma.

Methods: A cross-sectional study was conducted in the United Kingdom and Australia to obtain utilities for 14 adjuvant melanoma health states. One-on-one interviews were conducted using standard gamble; utility weights range from 0.0, dead, to 1.0, full health. Supplemental risk questions also were asked.

Results: Among 155 participants (52% male; mean age, 46 years) "adjuvant treatment no toxicities" (0.89) was most preferred, followed by "induction treatment" (0.88), and "no treatment" (0.86). Participants least preferred "cancer recurrence" (0.62); the utility for "cancer recurrence and 10-year survival with treatment" was 0.70. Disutilities for grade 2 toxicities ranged from -0.06 for fatigue to -0.13 for hypophysitis. The mean maximum acceptable risk of a life-threatening event ranged from 30% for a 6% increase in the chance of remaining cancer free over 3 years to 40% for an 18% increase; Australian respondents were willing to take higher risks.

Conclusion: Reproducible health utilities for adjuvant melanoma health states were obtained from the general population in two countries. These utilities can be incorporated into treatment-specific cost-effectiveness evaluations.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by Magil Institutional Review Board (Rockville, MD) and complied with the tenets of the Declaration of Helsinki. Written informed consent was obtained from all study participants.

Consent for publication

Not applicable.

Competing interests

MM: Consulting or Advisory Role: Amgen, Bristol-Myers Squibb, Clovis, GlaxoSmithKline, Immunocore (uncompensated), Merck, Roche (all compensated); Research Funding: Amgen, AstraZeneca, Bristol-Myers Squibb, Clovis, Eisai, GlaxoSmithKline, Immunocore, Medimmune, Merck, Pfizer, Roche, Vertex; Travel, Accommodations, Expenses: Merck, Roche. MBA: Consulting or Advisory Role: Amgen, Bristol-Myers Squibb, Caladrius, GlaxoSmithKline, Genentech Roche, Merck, Nektar, Novartis, Pfizer. KA: Consulting role: Bristol-Myers Squibb. PFW: Employment: Bristol-Myers Squibb. SK: Employment: Bristol-Myers Squibb; Stock or Other Ownership: Bristol-Myers Squibb; Research Funding: Bristol-Myers Squibb; Travel, Accommodations, Expenses: Bristol-Myers Squibb. JS: Employment: Bristol-Myers Squibb; Stock or Other Ownership: Bristol-Myers Squibb; Research Funding: Bristol-Myers Squibb. KB: Consulting role: Bristol-Myers Squibb.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Mean standard gamble utilities for treatment-related health states. *p < 0.05 for differences between countries
Fig. 2
Fig. 2
Mean disutilities for toxicity states: overall population
Fig. 3
Fig. 3
Risk-benefit tradeoff curve for UK, Australia, and overall
See this image and copyright information in PMC

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