Prostate cancer is one of the most diagnosed malignancies in the world, with many patients progressing to an advanced stage of the disease called metastatic castration-resistant prostate cancer (mCRPC). Due to the poor prognosis and incurable nature of mCRPC, maintaining or improving quality of life (QoL) has become an important goal of therapy for patients, caregivers and physicians QoL metrics are also essential in the approval and reimbursement of cancer therapies.
Quality of life can be measured using utility values, such as the EQ-5D family of instruments. The EQ-5D scales measure QoL through five dimensions of health – mobility, self-care, usual activities, pain and discomfort, and anxiety and depression – providing a generic measure of health utility and QoL that is recommended for use by many health technology assessment organizations. EQ-5D and other utility values are used to represent QoL in specific health state utility values (HSUVs) to calculate quality-adjusted life-years in cost-utility analyses.
As new therapies and treatment combinations are developed for mCRPC, utility values and QoL will continue to play a major role in the economic evaluations of these therapies. To provide a comprehensive review of the range of HSUVs in mCRPC, the Value & Evidence team at EVERSANA (Rhett Figliuzzi, Samantha Craigie, Sarah Walsh and Imtiaz Samjoo) – along with Dr. Elena Castro and the team at Pfizer Inc. (Alexander Niyazov and Jonathan Nazari) – conducted a systematic literature review with meta-analysis to summarize the available evidence on the topic.
Across the evidence, lower utility values were identified in patients receiving treatments in the second-line or later (2L+) mCRPC setting compared to the first-line (1L) setting. This trend was further supported by the meta-analysis conducted on EQ-5D utility values by line of therapy, where the pooled mean estimate of EQ-5D utility values in 2L+ were lower than in the 1L setting. The results of these analyses provide a valuable resource for those developing economic models and other analyses related to QoL, and they can be used to help inform or validate utility value inputs and to support drug reimbursement in mCRPC and highlight the need for more standardized QoL reporting.
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Author
Rhett is an Associate Manager on Evidence Synthesis team at EVERSANA and provides support on literature reviews and other evidence synthesis projects for pharmaceuticals and medical devices. Rhett joined EVERSANA in 2021 and has…
Samantha Craigie holds an MSc in Epidemiology and Biostatistics from the University of Western Ontario. As an Associate Director at EVERSANA in Evidence Synthesis, Samantha has led many global SLR and ITC projects for…
Sarah is a Manager on the Value & Evidence team at EVERSANA and provides statistical support and guidance on evidence synthesis projects. Sarah brings over six years of academic experience and a strong background…
As Senior Director of the Value & Evidence team at EVERSANA, Imtiaz leads evidence synthesis projects that support global HEOR initiatives involving systematic literature reviews, indirect treatment comparisons, and health economic modeling, to support reimbursement…