Disability weights for castration-resistant prostate cancer: an empirical investigation

• DOI: 10.33393/grhta.2022.2431
• Publication Date: 2022-11-14T10:52:01Z
• Authors: Ludovica Borsoi; Oriana Ciani; Rocco De Vivo; Giorgio Ivan Russo; Marcello Scarcia; Chiara De Fino; Patrizia Beccaglia; Irene Luccarini
• Keywords: Person-trade-off; Disease burden; 3. Good health; CASTRATION-RESISTANT PROSTATE CANCER, DISABILITY WEIGHTS, DISEASE BURDEN, PERSON-TRADE-OFF, VISUAL ANALOGUE SCALE; Disability weights; 03 medical and health sciences; 0302 clinical medicine; Visual analogue scale; Medical technology; Original Research Article; R855-855.5; Castration-resistant prostate cancer

Introduction: Health state valuation and diagnostic-therapeutic pathways at the junction between non-metastatic and metastatic castration-resistant prostate cancer (CRPC) are not well documented. We aimed at: (i) estimating the disability weights (DWs) for health states across a continuum of disease from asymptomatic non-metastatic (nmCRPC) to symptomatic metastatic state (mCRPC); (ii) mapping the diagnostic-therapeutic pathway of nmCRPC in Italy. Methods: Structured qualitative interviews were performed with clinical experts to gather information on nmCRPC clinical pathway. An online survey was administered to clinical experts to estimate DWs for four CRPC health states defined from interviews and literature review (i.e., nmCRPC, asymptomatic mCRPC, symptomatic mCRPC, mCRPC in progression during or after chemotherapy). Clinicians’ preferences for health states were elicited using the Person-Trade-Off (PTO) and Visual Analogue Scale (VAS) methods. DWs associated with each health state, from 0 (best imaginable health state) and 1 (worst imaginable health state), were estimated. Results: We found that the management of nmCRPC is heterogeneous across Italian regions and hospitals, especially with respect to diagnostic imaging techniques. DWs for PTO ranged from 0.415 (95% confidence interval [CI] 0.208-0.623) in nmCRPC to 0.740 (95% CI 0.560-0.920) in mCRPC, in progression during or after chemotherapy. DWs for VAS ranged between 0.246 (95% CI 0.131-0.361) in nmCRPC to 0.689 (95% CI 0.583-0.795) in mCRPC, in progression during or after chemotherapy. Conclusions: Estimated DWs suggest that delaying transition to a metastatic state might ease the disease burden at both patient and societal levels.