Introduction: Although cost−utility models are often used to estimate the value of treatments for
metastatic cancer, limited information is available on the utility of common treatment modalities.
Bisphosphonate treatment for bone metastases is frequently administered via intravenous infusion,
while a newer treatment is administered as a subcutaneous injection. This study estimated
the impact of these treatment modalities on health state preference.
Methods: Participants from the UK general population completed time trade-off interviews
to assess the utility of health state vignettes. Respondents first rated a health state representing
cancer with bone metastases. Subsequent health states added descriptions of treatment modalities
(ie, injection or infusion) to this basic health state. The two treatment modalities were presented
with and without chemotherapy, and infusion characteristics were varied by duration (30 minutes
or 2 hours) and renal monitoring.
Results: A total of 121 participants completed the interviews (52.1% female, 76.9% white).
Cancer with bone metastases had a mean utility of 0.40 on a standard utility scale (1 = full
health; 0 = dead). The injection, 30-minute infusion, and 2-hour infusion had mean disutilities
of −0.004, −0.02, and −0.04, respectively. The mean disutility of the 30-minute infusion was
greater with renal monitoring than without. Chemotherapy was associated with substantial
disutility (−0.17). When added to health states with chemotherapy, the mean disutilities of injection,
30-minute infusion, and 2-hour infusion were −0.02, −0.03, and −0.04, respectively. The
disutility associated with injection was significantly lower than the disutility of the 30-minute
and 2-hour infusions (P , 0.05), regardless of chemotherapy status.
Conclusion: Respondents perceived an inconvenience with each type of treatment modality,
but injections were preferred over infusions. The resulting utilities may be used in cost−utility
models examining the value of treatments for the prevention of skeletal-related events in patients
with bone metastases.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)