Objectives In recent years, a hotly debated topic has been the application of condition-specific utilities versus generic utilities for health technology assessment. The European Organization for the Research and Treatment of Cancer 30-item Core Quality of Life Questionnaire (QLQ-C30) is a widely used cancer-specific health profile. With the development of the Quality of Life Utility measure-Core 10 Dimensions (QLQ-C10D), data collected using the QLQ-C30 can be used to generate utilities to inform cost-effectiveness analyses (CEAs). This study aimed to assess the implications of using utilities based on the QLU-C10D versus the 3-level EQ-5D (EQ-5D-3L) for assessing the cost effectiveness of immuno-oncologic agents for treating metastatic melanoma.

Methods Quality of life from a clinical study CheckMate066 where both QLQ-C30 and EQ-5D-3L (Australian weights) was observed the basis of this study. The potential influence of the two instruments on cost effectiveness was assessed using a 3-state (progression-free, progression, dead) published model using an Australian societal perspective. Descriptive statistics and standard CEA outputs, such as acceptability curves, were used to examine differences between the utility measures.

Results Results Mean baseline utility values as measured by the QLU-C10D (mean=0.744, SD=0.219) were not statistically different (p=0.032) when compared to the EQ-5D (mean=0.735, SD=0.239). The model predicted a slightly higher number of quality-adjusted life years (QALYs) when applying EQ-5D instead of QLU-C10D utilities (1.87 vs. 1.74, respectively). This resulted in an incremental cost-effectiveness ratio of AU$39.1K when using EQ-5D utilities as opposed to AU$41.9K when using QLU-C10D utilities. Acceptability curves based on the two sets of utilities were almost indistinguishable.

Conclusions The results of this study demonstrate that the disease specific utility represented by QLU-C10D yielded similar results as EQ-5D which is consistent with emerging findings from independent investigations.