Utilities associated with subcutaneous injections and intravenous infusions for treatment of patients with bone metastases

摘要

Introduction: Although cost−utility models are often used to estimate the value of treatments forudmetastatic cancer, limited information is available on the utility of common treatment modalities.udBisphosphonate treatment for bone metastases is frequently administered via intravenous infusion,udwhile a newer treatment is administered as a subcutaneous injection. This study estimatedudthe impact of these treatment modalities on health state preference.udMethods: Participants from the UK general population completed time trade-off interviewsudto assess the utility of health state vignettes. Respondents first rated a health state representingudcancer with bone metastases. Subsequent health states added descriptions of treatment modalitiesud(ie, injection or infusion) to this basic health state. The two treatment modalities were presentedudwith and without chemotherapy, and infusion characteristics were varied by duration (30 minutesudor 2 hours) and renal monitoring.udResults: A total of 121 participants completed the interviews (52.1% female, 76.9% white).udCancer with bone metastases had a mean utility of 0.40 on a standard utility scale (1 = fulludhealth; 0 = dead). The injection, 30-minute infusion, and 2-hour infusion had mean disutilitiesudof −0.004, −0.02, and −0.04, respectively. The mean disutility of the 30-minute infusion wasudgreater with renal monitoring than without. Chemotherapy was associated with substantialuddisutility (−0.17). When added to health states with chemotherapy, the mean disutilities of injection,ud30-minute infusion, and 2-hour infusion were −0.02, −0.03, and −0.04, respectively. Theuddisutility associated with injection was significantly lower than the disutility of the 30-minuteudand 2-hour infusions (P , 0.05), regardless of chemotherapy status.udConclusion: Respondents perceived an inconvenience with each type of treatment modality,udbut injections were preferred over infusions. The resulting utilities may be used in cost−utilityudmodels examining the value of treatments for the prevention of skeletal-related events in patientsudwith bone metastases.