OBJECTIVES: A systematic review was conducted to identify utility estimates for patients with melanoma in the adjuvant setting and to evaluate suitability for use in economic evaluations.
METHODS: MEDLINE, Embase, EconLit, Cochrane, and BIOSIS were searched from 1998 to 2018 (inclusive). Published literature and relevant health technology assessments, conference abstracts, and bibliographies in English were reviewed. Studies reporting utility estimates for adult patients with melanoma (any stage) treated in the adjuvant setting were included. Data were extracted and assessed per National Institute for Health and Care Excellence requirements and for suitability for modelling patients’ utility from start of adjuvant treatment to death.
RESULTS: The searches identified 11 studies reporting utility estimates. Ten reported utility weights for health states, while 1 presented changes from baseline. Of the 10 studies that provided utility weights, 2 reported estimates during interferon treatment and 1 during interferon or ipilimumab treatment. The remaining 7 studies did not consider specific interventions. Four studies used the EQ-5D, of which 2 reported the value set (United Kingdom [UK] and Belgian). In the study utilizing the UK value set, EQ-5D estimates were mean 0.79 (95% CI, 0.74-0.84) for disease-free patients, 0.80 (0.71-0.88) for locoregional recurrence, and 0.71 (0.62-0.80) for distant metastasis and/or terminal disease. One study used the AQoL-6D, an alternative, generic, preference-based measure, 2 used vignette study designs, 3 were cost-utility models using utility values from published literature, and 1 estimated utility values from clinical opinion.
CONCLUSIONS: Although it is difficult to draw comparisons between estimates due to the heterogeneity in methods and health state definitions, 1 study did find utilities decreased with distant metastasis and/or terminal disease. In the adjuvant setting, there are limited high-quality health state utility estimates published that can be used for economic evaluations.
