Objectives
Despite impaired quality of life, limited studies have evaluated health utility among patients with newly diagnosed acute myeloid leukemia (ND-AML) who are ineligible for intensive chemotherapy. The Viale-A and Viale-C studies are the only trials that collected EuroQoL 5-Dimension (EQ-5D) data for patients in different health states. The study aims to estimate the health state utility values among this population across multiple countries.
Methods
EQ-5D utility scores were estimated based on the pooled data from all patients with a baseline and post-baseline assessment in Viale-A and/or C trials. The utility scores were calculated using published country-specific value sets in the United Kingdom (UK), France, Canada, Sweden, Germany, Denmark, China, and South Korea. Three health states were assessed, event-free survival (EFS) with complete remission/complete remission with incomplete blood count recovery (CR/CRi), EFS without CR/CRi, and progressive/relapsed disease (PD/RL). The utility values (range: 0 [death] - 1 [best/perfect health state]) for these health states were estimated via a linear mixed-effects model to account for the correlations among repeated assessments for the same patient. The model also adjusted for grade 3/4 adverse events.
Results
The analysis included 390 and 186 patients from Viale-A and Viale-C, respectively. For the UK, the utility value based on the pooled trial data was 0.747 (standard error [SE] = 0.013) for EFS with CR/CRi, 0.725 (SE = 0.014) for EFS without CR/CRi, and 0.628 (SE = 0.017) for PD/RL. For other countries, the utility values ranged from 0.693 to 0.897 for EFS with CR/CRi, from 0.657 to 0.857 for EFS without CR/CRi, and from 0.569 to 0.793 for PD/RL.
Conclusions
EFS with CR/CRi was associated with the highest utility scores, followed by EFS without CR/CRi and PD/RL for ND-AML patients who are ineligible for intensive chemotherapy in all countries.
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