Cancer specific health utilities - QLU-C10D country value sets for Belgium, Hungary, Portugal and the Republic of Korea – an international valuation study

The QLU-C10D is a preference-based measure of health-related quality of life (HRQL) for health economic evaluation in cancer patients. QLU-C10D health state utility values (HSUV) are estimated from QLQ-C30 data weighted by country-specific value sets. To further integrate the QLU-C10D in the international health-economic landscape, we developed country value sets for Belgium, Hungary, Portugal, and the Republic of Korea. In each country, online quota sampling was deployed to enrol participants representative of the general population for sex- and age- groups. We assessed socioeconomic information of participants. The standard EORTC QLU-C10D valuation protocol, a discrete-choice experiment, was used to elicit the country-specific value sets. Conditional logistic regressions were used to estimate general population preferences for survival time and impaired health domains. Utility decrements were estimated as the ratio of the coefficient for impaired health domains and the time coefficient. We used weighting to adjust for oversampling of higher education participants. Between September 2023 and February 2024, 4074 participants from the four countries were enrolled and included in analyses. Participants in all countries showed the greatest preference for the health domain of ‘physical functioning’, resulting in utility decrements of -0.182 to -0.372 for the impairment level ‘very much’. This was followed by the health domains of ‘Pain’, ‘Role Functioning’, and ‘Social Functioning’, which ranged between − 0.096 to -0.190 for the impairment level ‘very much’ across the four countries. Non-monotonicities were observed in all four countries, thus adjustments for non-monotonicity were performed for each country value set. The value sets of the QLU-C10D for the countries of Belgium, Hungary, Portugal and the Republic of Korea allow health-decision makers in these countries to estimate cancer-specific HSUVs, thereby incorporating the HRQL data collected with the QLQ-C30 into health economic decision-making.