Health state utilities associated with treatment options for acute myeloid leukemia (AML)

Figures & data

Table 1. Demographic characteristics.

	Edinburgh (n = 100)	London (n = 100)	Participants in the analysis sample (n = 200)	p-value^a
Age (Mean, SD)	45.0 (15.8)	46.1 (15.4)	45.5 (15.6)	0.64
Gender, n (%)
Male	50 (50.0%)	52 (52.0%)	102 (51.0%)	0.78
Female	50 (50.0%)	48 (48.0%)	98 (49.0%)
Ethnic/Racial background, n (%)
White	90 (90.0%)	54 (54.0%)	144 (72.0%)	<0.0001
Mixed^b	4 (4.0%)	6 (6.0%)	10 (5.0%)
Asian	5 (5.0%)	20 (20.0%)	25 (12.5%)
Black	1 (1.0%)	16 (16.0%)	17 (8.5%)
Other^c	0 (0.0%)	4 (4.0%)	4 (2.0%)
Marital status, n (%)
Not married^d	55 (55.0%)	66 (66.0%)	121 (60.5%)	0.11
Married/Cohabitating/Living with partner	45 (45.0%)	34 (34.0%)	79 (39.5%)
Other	0 (0.0%)	0 (0.0%)	0 (0.0%)
Employment status, n (%)
Full-time work	40 (40.0%)	39 (39.0%)	79 (39.5%)	0.88
Part-time work	24 (24.0%)	27 (27.0%)	51 (25.5%)
Other^e	36 (36.0%)	34 (34.0%)	70 (35.0%)
Education level, n (%)
University degree	44 (44.0%)	40 (40.0%)	84 (42.0%)	0.57
No University degree	56 (56.0%)	60 (60.0%)	116 (58.0%)

^a p-values for comparisons between Edinburgh and London are based on t-tests for continuous variables and Chi-square analyses for categorical variables.

^b Mixed includes White and Black Caribbean; White and Black African; White and Asian; and other mixed/multiple ethnic groups as reported by respondents.

^c Other Ethnic/Racial background includes Arab and other, as reported by respondents (verbatim text responses included: Iranian, half British/Iraqi, and British Turkish Cypriot).

^d Not married includes single, divorced, separated, and widowed, as reported by the respondents.

^e Other employment includes homemaker, student, unemployed, retired, disabled, and unspecified, as reported by the respondents.

Abbreviations. SD, standard deviation.

Table 2. Utilities of Group 1 health states (n = 193).

	Differences among the chemotherapy health states
Health states	Hospital stay (weeks)	Infusion duration	Potential side-effects	Mean utility^a	SD	95% CI
B1: Remission, between treatment				0.66	0.29	0.61–0.70
C1: Induction, 7 + 3	4	24 h per day for 7 days	Complete hair loss, risk of infection, feeling very fatigued	0.50	0.32	0.46–0.55
C2: Induction, CPX-351	5	90 min on days 1, 3, and 5	Thinning hair, risk of infection, feeling a little fatigued	0.55	0.32	0.50–0.59
D1: Consolidation, 5 + 2	1	24 h per day for 5 days	Complete hair loss, risk of infection, feeling very fatigued	0.54	0.31	0.50–0.59
D2: Consolidation, HiDAC	1	4 h twice each day on days 1, 3, and 5	Thinning hair, risk of infection, feeling very fatigued	0.58	0.30	0.54–0.62
D3: Consolidation, CPX-351,inpatient	1	90 min on days 1 and 3	Thinning hair, risk of infection, feeling a little fatigued	0.61	0.29	0.57–0.65
D4: Consolidation, CPX-351, outpatient	0	90 min on days 1 and 3	Thinning hair, risk of infection, feeling a little fatigued	0.62	0.29	0.58–0.66

^a TTO scores are on a scale anchored with 0 representing dead and 1 representing full health.

Abbreviations. CI, confidence interval; HiDAC, high-dose cytarabine; SD, standard deviation.

Table 3. Utilities of the Group 2 health states (n = 193).

Health state	Mean utility^a	SD	95% CI
A: AML	0.55	0.31	0.51–0.59
B2: Durable remission	0.86	0.18	0.83–0.88
E1: BSC	0.52	0.32	0.47–0.56
E2: HMA	0.48	0.33	0.43–0.53
F: Transplant	0.65	0.28	0.61–0.69

^a TTO scores are on a scale anchored with 0 representing dead and 1 representing full health.

Abbreviations. AML, acute myeloid leukemia; BSC, best supportive care; CI, confidence interval; HMA, hypomethylating agents; SD, standard deviation.

Table 4. Differences among health state utilities.^a

Health state utility differences	Mean	SD	95% CI
Disutilities of chemotherapy regimens
C1 – B1: Disutility of induction, 7 + 3	−0.15	0.18	−0.18 to −0.13
C2 – B1: Disutility of induction, CPX-351	−0.11	0.15	−0.13 to −0.09
D1 – B1: Disutility of consolidation, 5 + 2	−0.11	0.15	−0.13 to −0.09
D2 – B1: Disutility of consolidation, HiDAC	−0.08	0.12	−0.09 to −0.06
D3 – B1: Disutility of consolidation, CPX-351, inpatient	−0.05	0.09	−0.06 to −0.03
D4 – B1: Disutility of consolidation, CPX-351, outpatient	−0.03	0.07	−0.04 to −0.02
F – B2: Disutility of transplant	−0.21	0.26	−0.25 to −0.17
Utility difference between induction health states
C1 – C2: 7 + 3 vs CPX-351	−0.04	0.12	−0.06 to −0.03
Utility differences between consolidation health states
D1 – D2: 5 + 2 vs HiDAC	−0.03	0.08	−0.05 to −0.02
D1 – D3: 5 + 2 vs inpatient CPX-351	−0.07	0.12	−0.08 to −0.05
D1 – D4: 5 + 2 vs outpatient CPX-351	−0.08	0.13	−0.10 to −0.06
D2 – D3: HiDAC vs inpatient CPX-351	−0.03	0.08	−0.04 to −0.02
D2 – D4: HiDAC vs outpatient CPX-351	−0.04	0.10	−0.06 to −0.03
D3 – D4: Inpatient CPX-351 vs outpatient CPX-351	−0.01	0.05	−0.02 to −0.00

^a Of the 200 participants, seven who began with the group 1 health states did not continue with group 2. Likewise, seven participants who began with group 2 did not complete group 1. Therefore, each health state was valued by 193 respondents.

Abbreviations. CI, confidence interval; HiDAC, high-dose cytarabine; SD, standard deviation.

Data availability statement

Data are available from the authors upon request.