Utilities for advanced basal cell carcinoma

Area of Science:

• Oncology
• Health Economics
• Patient-Reported Outcomes

Background:

• Advanced basal cell carcinoma (aBCC) presents challenges when standard treatments are not feasible, potentially leading to disfigurement.
• aBCC can negatively affect patients' psychological well-being, quality of life (QoL), and survival.
• Quantifying the societal value of health states associated with aBCC is crucial for resource allocation and treatment evaluation.

Purpose of the Study:

• To determine societal utility values for various health states related to advanced basal cell carcinoma (aBCC).
• To utilize the time trade-off (TTO) methodology to capture these values from the general public.

Main Methods:

• Developed nine distinct health states for aBCC, including complete response, partial response, stable disease, and progressive disease, with varying lesion sizes.
• Employed the time trade-off (TTO) method with 100 UK general public participants.
• Participants made choices between experiencing a health state for 10 years versus full health for a shorter duration (10-x years) to derive utility scores.

Main Results:

• The complete response (CR) state had the highest mean utility score (0.94), indicating a minimal impact on QoL.
• Progressive disease (PD) with a 6 cm lesion yielded the lowest mean utility score (0.67), signifying the greatest negative impact on QoL.
• Utility scores varied across different states of response and lesion size, reflecting the heterogeneous burden of aBCC.

Conclusions:

• Societal valuation indicates a significant quality of life burden associated with advanced basal cell carcinoma (aBCC), even in stable or treated conditions.
• The rarity and variable nature of aBCC pose challenges in characterizing all patient presentations for utility assessment.
• Findings underscore the importance of considering patient-reported outcomes and societal values in managing advanced basal cell carcinoma.