Health State Utilities Associated with Treatment Options for Acute Myeloid Leukemia (AML)

OBJECTIVES: AML treatment typically involves initial remission induction therapy (usually chemotherapy with cytarabine plus an anthracycline, such as daunorubicin [e.g., 7+3 regimen]) followed by post-induction consolidation therapy (additional chemotherapy and/or blood/marrow transplant [BMT]). CPX-351 is a novel dual-drug liposomal encapsulation of cytarabine and daunorubicin that delivers a synergistic drug ratio. Compared with 7+3, CPX-351 improves overall survival in older adults with untreated high-risk or secondary AML and differs in its mode of administration. The purpose of this study was to estimate health state utilities associated with AML treatment strategies. METHODS: In time trade-off interviews with a 1-year time horizon, participants from the UK general population (London, Edinburgh) valued 12 health states drafted based on literature and clinician interviews. To identify disutility associated with chemotherapy, two types of induction and four types of consolidation were added to an otherwise identical health state describing AML in temporary remission. The decrease in utility when adding these treatment regimens represents the disutility of each type of induction/consolidation. Five additional health states were valued to estimate utilities associated with other AML treatments. RESULTS: 200 participants completed interviews. Mean (SD) utilities were 0.55 (0.31) for pre-treatment AML and 0.66 (0.29) for AML in temporary remission. The addition of any chemotherapy to one year of temporary remission significantly decreased utility (P