Utility and work productivity data for economic evaluation of breast cancer therapies in the Netherlands and Sweden

Clin Ther. 2013 Apr;35(4):e1-7. doi: 10.1016/j.clinthera.2013.03.009. Epub 2013 Mar 28.


Objective: This study aimed to estimate utility values in laypeople and productivity loss for women with breast cancer in Sweden and the Netherlands.

Methods: To capture utilities, validated health state vignettes were used, which were translated into Dutch and Swedish. They described progressive disease, stable disease, and 7 grade 3/4 adverse events. One hundred members of the general public in each country rated the states using the visual analog scale and time trade-off method. To assess productivity, women who had recently completed or were currently receiving treatment for early or advanced breast cancer (the Netherlands, n = 161; Sweden, n = 52) completed the Work Productivity and Activity Impairment-General Health (WPAI-GH) questionnaire. Data were analyzed using means (SD).

Results: The utility study showed that the Swedish sample rated progressive and stable disease (mean, 0.61 [0.07] and 0.81 [0.05], respectively) higher than did the Dutch sample (0.49 [0.06] and 0.69 [0.05]). The health states incorporating the toxicities in both countries produced similar mean scores. Results of the WPAI-GH showed that those currently receiving treatment reported productivity reductions of 69% (the Netherlands) and 72% (Sweden); those who had recently completed therapy reported reductions of 41% (the Netherlands) and 40% (Sweden).

Conclusions: The differences in the utility scores between the 2 countries underline the importance of capturing country-specific values. The significant impact of adverse events on health-related quality of life was also highlighted. The WPAI-GH results demonstrated how the negative impact of breast cancer on productivity persists after women have completed their treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Breast Neoplasms / therapy*
  • Cost-Benefit Analysis*
  • Efficiency*
  • Female
  • Humans
  • Middle Aged
  • Netherlands
  • Sweden
  • Young Adult