Health-related quality of life and costs in prostate cancer

Research output: ThesisDoctoral ThesisCollection of Articles

Abstract

Scientific evidence based on health economic evaluations is needed to enable decisions-makers to make informed decisions on resource allocations within health care systems. Usually the economic evaluations take place within health technology assessment (HTA). The use of health economic evaluations has increased during the last two decades and will hopefully contribute towards making the best possible use of limited health care resources. Prostate cancer (PC) is the most frequently diagnosed cancer in men accounting for 29% of all the cancers diagnosed in men in Finland. There are almost 50,000 men in Finland currently living with PC. The prevalence of PC is expected to rise with aging population and improved diagnostics and treatment options. This may also increase the burden from PC on the society and, consequently, resource optimization is warranted. Health-related quality of life (HRQoL) assessments in PC is an evolving field but, based on the literature, the use of preference-based single index measures to generate health state utilities or values valid for the estimation of quality adjusted life years (QALY) gained, is scarce. This is problematic, as health state utility estimates are an integral component of cost-utility analysis, which can be considered the gold standard method in health economics today. The general aim of this thesis was to study HRQoL and costs in different states of PC. HRQoL was assessed with one cancer-specific (EORTC QLQ-C30) and two generic (EQ-5D-3L and 15D) HRQoL instruments. Data (630 patients) were collected in the Helsinki and Uusimaa Hospital District in a cross-sectional setting. In addition, costs were also collected for these patients as incremental costs compared to age, gender and place of residence standardized peers. All evaluated HRQoL instruments provided valuable insight into patients’ overall HRQoL. HRQoL remained on a relatively high level until the disease progressed. Symptoms of fatigue and pain, and the background variables of financial difficulties and age, were the most important factors associated with poor HRQoL. Direct costs related to different states of PC are significant. However, productivity losses and costs of informal care also play a major role when estimating the total economic burden of PC. Excluding such a large share of costs from cost-effectiveness considerations might have a significant impact on the decision making pro¬cess of health economic evaluations or HTA. The single-index HRQoL instruments considered here (EQ-5D-3L and 15D) should not be considered interchangeable in health economic evaluations, especially in the case where HRQoL values are low or differ significantly from those of age-standardized peers.
Original languageEnglish
Supervisors/Advisors
  • Sintonen, Harri, Supervisor
  • Roine, Risto Paavo Antero, Supervisor
  • Taari, Kimmo, Supervisor
Place of PublicationHelsinki
Publisher
Print ISBNs978-951-51-5085-1
Electronic ISBNs978-951-51-5086-8
Publication statusPublished - 2019
MoE publication typeG5 Doctoral dissertation (article)

Fields of Science

  • Prostatic Neoplasms
  • +classification
  • +economics
  • +epidemiology
  • +psychology
  • Cost of Illness
  • Quality-Adjusted Life Years
  • Cost-Benefit Analysis
  • Quality of Life
  • Male
  • Pain
  • Aging
  • Survival Rate
  • Rehabilitation
  • Work
  • Socioeconomic Factors
  • Family
  • Fatigue
  • Health Status
  • Palliative Care
  • Radiotherapy
  • Retirement
  • Neoplasm Metastasis
  • 3122 Cancers
  • 3142 Public health care science, environmental and occupational health

Cite this

Torvinen, Saku. / Health-related quality of life and costs in prostate cancer. Helsinki : Helsingin yliopisto, 2019. 79 p.
@phdthesis{b14d364895064a21b983237383c8ce78,
title = "Health-related quality of life and costs in prostate cancer",
abstract = "Scientific evidence based on health economic evaluations is needed to enable decisions-makers to make informed decisions on resource allocations within health care systems. Usually the economic evaluations take place within health technology assessment (HTA). The use of health economic evaluations has increased during the last two decades and will hopefully contribute towards making the best possible use of limited health care resources. Prostate cancer (PC) is the most frequently diagnosed cancer in men accounting for 29{\%} of all the cancers diagnosed in men in Finland. There are almost 50,000 men in Finland currently living with PC. The prevalence of PC is expected to rise with aging population and improved diagnostics and treatment options. This may also increase the burden from PC on the society and, consequently, resource optimization is warranted. Health-related quality of life (HRQoL) assessments in PC is an evolving field but, based on the literature, the use of preference-based single index measures to generate health state utilities or values valid for the estimation of quality adjusted life years (QALY) gained, is scarce. This is problematic, as health state utility estimates are an integral component of cost-utility analysis, which can be considered the gold standard method in health economics today. The general aim of this thesis was to study HRQoL and costs in different states of PC. HRQoL was assessed with one cancer-specific (EORTC QLQ-C30) and two generic (EQ-5D-3L and 15D) HRQoL instruments. Data (630 patients) were collected in the Helsinki and Uusimaa Hospital District in a cross-sectional setting. In addition, costs were also collected for these patients as incremental costs compared to age, gender and place of residence standardized peers. All evaluated HRQoL instruments provided valuable insight into patients’ overall HRQoL. HRQoL remained on a relatively high level until the disease progressed. Symptoms of fatigue and pain, and the background variables of financial difficulties and age, were the most important factors associated with poor HRQoL. Direct costs related to different states of PC are significant. However, productivity losses and costs of informal care also play a major role when estimating the total economic burden of PC. Excluding such a large share of costs from cost-effectiveness considerations might have a significant impact on the decision making pro¬cess of health economic evaluations or HTA. The single-index HRQoL instruments considered here (EQ-5D-3L and 15D) should not be considered interchangeable in health economic evaluations, especially in the case where HRQoL values are low or differ significantly from those of age-standardized peers.",
keywords = "Prostatic Neoplasms, +classification, +economics, +epidemiology, +psychology, Cost of Illness, Quality-Adjusted Life Years, Cost-Benefit Analysis, Quality of Life, Male, Pain, Aging, Survival Rate, Rehabilitation, Work, Socioeconomic Factors, Family, Fatigue, Health Status, Palliative Care, Radiotherapy, Retirement, Neoplasm Metastasis, 3122 Cancers, 3142 Public health care science, environmental and occupational health",
author = "Saku Torvinen",
note = "M1 - 79 s. + liitteet",
year = "2019",
language = "English",
isbn = "978-951-51-5085-1",
series = "Dissertationes Scholae Doctoralis Ad Sanitatem Investigandam Universitatis Helsinkiensis",
publisher = "Helsingin yliopisto",
number = "25/2019",
address = "Finland",

}

Health-related quality of life and costs in prostate cancer. / Torvinen, Saku.

Helsinki : Helsingin yliopisto, 2019. 79 p.

Research output: ThesisDoctoral ThesisCollection of Articles

TY - THES

T1 - Health-related quality of life and costs in prostate cancer

AU - Torvinen, Saku

N1 - M1 - 79 s. + liitteet

PY - 2019

Y1 - 2019

N2 - Scientific evidence based on health economic evaluations is needed to enable decisions-makers to make informed decisions on resource allocations within health care systems. Usually the economic evaluations take place within health technology assessment (HTA). The use of health economic evaluations has increased during the last two decades and will hopefully contribute towards making the best possible use of limited health care resources. Prostate cancer (PC) is the most frequently diagnosed cancer in men accounting for 29% of all the cancers diagnosed in men in Finland. There are almost 50,000 men in Finland currently living with PC. The prevalence of PC is expected to rise with aging population and improved diagnostics and treatment options. This may also increase the burden from PC on the society and, consequently, resource optimization is warranted. Health-related quality of life (HRQoL) assessments in PC is an evolving field but, based on the literature, the use of preference-based single index measures to generate health state utilities or values valid for the estimation of quality adjusted life years (QALY) gained, is scarce. This is problematic, as health state utility estimates are an integral component of cost-utility analysis, which can be considered the gold standard method in health economics today. The general aim of this thesis was to study HRQoL and costs in different states of PC. HRQoL was assessed with one cancer-specific (EORTC QLQ-C30) and two generic (EQ-5D-3L and 15D) HRQoL instruments. Data (630 patients) were collected in the Helsinki and Uusimaa Hospital District in a cross-sectional setting. In addition, costs were also collected for these patients as incremental costs compared to age, gender and place of residence standardized peers. All evaluated HRQoL instruments provided valuable insight into patients’ overall HRQoL. HRQoL remained on a relatively high level until the disease progressed. Symptoms of fatigue and pain, and the background variables of financial difficulties and age, were the most important factors associated with poor HRQoL. Direct costs related to different states of PC are significant. However, productivity losses and costs of informal care also play a major role when estimating the total economic burden of PC. Excluding such a large share of costs from cost-effectiveness considerations might have a significant impact on the decision making pro¬cess of health economic evaluations or HTA. The single-index HRQoL instruments considered here (EQ-5D-3L and 15D) should not be considered interchangeable in health economic evaluations, especially in the case where HRQoL values are low or differ significantly from those of age-standardized peers.

AB - Scientific evidence based on health economic evaluations is needed to enable decisions-makers to make informed decisions on resource allocations within health care systems. Usually the economic evaluations take place within health technology assessment (HTA). The use of health economic evaluations has increased during the last two decades and will hopefully contribute towards making the best possible use of limited health care resources. Prostate cancer (PC) is the most frequently diagnosed cancer in men accounting for 29% of all the cancers diagnosed in men in Finland. There are almost 50,000 men in Finland currently living with PC. The prevalence of PC is expected to rise with aging population and improved diagnostics and treatment options. This may also increase the burden from PC on the society and, consequently, resource optimization is warranted. Health-related quality of life (HRQoL) assessments in PC is an evolving field but, based on the literature, the use of preference-based single index measures to generate health state utilities or values valid for the estimation of quality adjusted life years (QALY) gained, is scarce. This is problematic, as health state utility estimates are an integral component of cost-utility analysis, which can be considered the gold standard method in health economics today. The general aim of this thesis was to study HRQoL and costs in different states of PC. HRQoL was assessed with one cancer-specific (EORTC QLQ-C30) and two generic (EQ-5D-3L and 15D) HRQoL instruments. Data (630 patients) were collected in the Helsinki and Uusimaa Hospital District in a cross-sectional setting. In addition, costs were also collected for these patients as incremental costs compared to age, gender and place of residence standardized peers. All evaluated HRQoL instruments provided valuable insight into patients’ overall HRQoL. HRQoL remained on a relatively high level until the disease progressed. Symptoms of fatigue and pain, and the background variables of financial difficulties and age, were the most important factors associated with poor HRQoL. Direct costs related to different states of PC are significant. However, productivity losses and costs of informal care also play a major role when estimating the total economic burden of PC. Excluding such a large share of costs from cost-effectiveness considerations might have a significant impact on the decision making pro¬cess of health economic evaluations or HTA. The single-index HRQoL instruments considered here (EQ-5D-3L and 15D) should not be considered interchangeable in health economic evaluations, especially in the case where HRQoL values are low or differ significantly from those of age-standardized peers.

KW - Prostatic Neoplasms

KW - +classification

KW - +economics

KW - +epidemiology

KW - +psychology

KW - Cost of Illness

KW - Quality-Adjusted Life Years

KW - Cost-Benefit Analysis

KW - Quality of Life

KW - Male

KW - Pain

KW - Aging

KW - Survival Rate

KW - Rehabilitation

KW - Work

KW - Socioeconomic Factors

KW - Family

KW - Fatigue

KW - Health Status

KW - Palliative Care

KW - Radiotherapy

KW - Retirement

KW - Neoplasm Metastasis

KW - 3122 Cancers

KW - 3142 Public health care science, environmental and occupational health

M3 - Doctoral Thesis

SN - 978-951-51-5085-1

T3 - Dissertationes Scholae Doctoralis Ad Sanitatem Investigandam Universitatis Helsinkiensis

PB - Helsingin yliopisto

CY - Helsinki

ER -

Torvinen S. Health-related quality of life and costs in prostate cancer. Helsinki: Helsingin yliopisto, 2019. 79 p. (Dissertationes Scholae Doctoralis Ad Sanitatem Investigandam Universitatis Helsinkiensis; 25/2019).