Estimation of Health Utility Values for Health States in Head and Neck Cancers Using Real-World Data

Krishnakumar Thankappan; Shivali Kamath; Lakshmi Ravunniarth Menon; Tejal Patel; Deepak Balasubramanian; Manu Raj; Moni Abraham Kuriakose; Sujha Subramanian; Subramania Iyer

doi:10.1016/j.vhri.2025.101576

Estimation of Health Utility Values for Health States in Head and Neck Cancers Using Real-World Data

Value Health Reg Issues. 2026 Jan 5:54:101576. doi: 10.1016/j.vhri.2025.101576. Online ahead of print.

Authors

Krishnakumar Thankappan¹, Shivali Kamath², Lakshmi Ravunniarth Menon², Tejal Patel², Deepak Balasubramanian², Manu Raj³, Moni Abraham Kuriakose⁴, Sujha Subramanian⁵, Subramania Iyer²

Affiliations

¹ Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India. Electronic address: drkrishnakumart@yahoo.co.in.
² Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India.
³ Department of Public Health Research, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India.
⁴ Karkinos Health Care, Kochi, Kerala, India.
⁵ Implenomics, Dover, DE, USA.

PMID: 41494233
DOI: 10.1016/j.vhri.2025.101576

Abstract

Objectives: To generate India-specific health state utility values for head and neck cancers (HNCs) using EuroQol 5-Dimension 5-Level (EQ-5D-5L) and EuroQol Visual Analog Scale (EQ-VAS) instruments, enabling context-relevant cost-utility analyses and health technology assessments.

Methods: A cross-sectional study was conducted at a tertiary HNC center in India from July 2023 to June 2024. Adults with confirmed HNCs across 53 predefined health states were enrolled. A health state is a specific condition of overall well-being, represented by a utility value indicating how preferable it is compared with perfect health or death. Utility scores were derived from the EQ-5D-5L index using the Indian tariff set and the EQ-VAS. Utility variations across treatment phases, tumor subsites, stage, and comorbidity status were also examined.

Results: Of 767 recruited patients, 753 were included for analysis across 48 health states, excluding 5 health states with less sample size. The mean EQ-5D-5L utility was 0.84 (SD 0.20), significantly higher than EQ-VAS (mean 0.73, SD 0.18; P < .001). Utilities varied significantly across treatment phases (P < .001). Clinically, patients in active treatment and palliative recurrence had the poorest perceived health, whereas those in remission showed the highest utility, mirroring expected functional recovery patterns. EQ-5D-5L produced consistently higher utility values than EQ-VAS, reflecting differences between population-weighted and self-perceived health assessments.

Conclusions: To our knowledge, this is the first Indian data set of real-world health state utility values in HNC. These values provide essential inputs for economic evaluations and health technology assessments in oncology, supporting more accurate, locally relevant healthcare decision making in resource-limited settings.

Keywords: EQ VAS; EQ-5D-5L; head and neck cancer; health utility; patient reported outcomes.