Quality of life valuations of HPV-associated cancer health states by the general population
- 1CSL Biotherapies, Parkville, Victoria, Australia
- 2Colorectal Surgery, The Alfred Hospital, Melbourne, Victoria, Australia
- 3Urology Sydney, The St George Hospital, Kogarah, New South Wales, Australia
- 4Oral Pathology, Dental School, The University of Adelaide, Adelaide, South Australia, Australia
- 5Gynaecological Oncology, Westmead Hospital, Westmead, New South Wales, Australia
- 6Pretium Pty Ltd, Sydney, New South Wales, Australia
- Correspondence to Dr E Lynne Conway, CSL Biotherapies, 45 Poplar Road, Parkville, VIC 3052, Australia;
Contributors ELC was involved in the study design, the interpretation of data and the writing of the report. JA was involved in the study design, the interpretation of data, the writing of the report and also conducted the survey and the statistical analysis. KCP, WJL, GLR and GW were involved in the development of the health state descriptions and background information for the survey and reviewed the manuscript before submission. All authors were involved in the decision to submit the manuscript for publication. The publication of the study results was not contingent on the approval of the sponsor company. All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
- Accepted 30 April 2012
- Published Online First 29 May 2012
Objectives To obtain health-related quality of life valuations (ie, utilities) for human papillomavirus (HPV)-related cancer health states of vulval, vaginal, penile, anal and oropharyngeal cancers for use in modelling cost-effectiveness of prophylactic HPV vaccination.
Methods Written case descriptions of each HPV-associated cancer describing the ‘average’ patient surviving after the initial cancer diagnosis and treatment were developed in consultation with oncology clinicians. A general overview, standard gamble questionnaire for each health state and a quiz was conducted in 120 participants recruited from the general population.
Results In the included population sample (n=99), the average age was 43 years (range = 18–70 years) with 54% men, 44% never married/43% married, 76% education beyond year 12 and 39% employed full-time. The utility values for the five health states were 0.57 (95% CI 0.52 to 0.62) for anal cancer, 0.58 (0.53 to 0.63) for oropharyngeal cancer, 0.59 (0.54 to 0.64) for vaginal cancer, 0.65 (0.60 to 0.70) for vulval cancer and 0.79 (0.74 to 0.84) for penile cancer. Participants demonstrated a very good understanding of the symptoms, diagnosis and treatment of these cancers with a mean score of 9 (SD=1.1) on a 10-item quiz.
Conclusions This study provides utility estimates for the specific HPV-related cancers of vulval, vaginal, penile, anal and oropharyngeal cancers valued by a general population sample using standard gamble. The results demonstrate considerable quality of life impact associated with surviving these cancers that will be important to incorporate into modelling cost-effectiveness of prophylactic HPV vaccination in different populations.
Funding This study was funded by CSL Biotherapies, a subsidiary of CSL Limited. CSL Limited is a financial beneficiary of sales of Gardasil and Cervarix; CSL Biotherapies distributes Gardasil in Australia and New Zealand.
Competing interests ELC is an employee of CSL Biotherapies and also owns shares in CSL Limited. JA is an employee of Pretium, a consultancy engaged by CSL Biotherapies to undertake the study. GW has been involved in the research studies for Gardasil and has acted as a consultant and received honoraria for speaking from Merck and CSL Biotherapies. He received no financial compensation for this study. WJL has acted as a consultant for CSL Biotherapies. He received no financial compensation for this study.
Provenance and peer review Not commissioned; externally peer reviewed.
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