PURPOSE: The aim of the study was to elicit societal utility values for different stages of advanced Non Small Cell Lung Cancer including responding disease, stable disease contrasting intravenous (IV) and oral treatment, progressive disease without treatment, and an ‘end of life' health state.

METHODS: Metastatic disease based health state descriptions were adapted to describe metastatic lung cancer health states. Content validation was performed through interviews with oncologists (n=5). Thematic saturation was achieved and changes were made. Revised health states were then re-reviewed by the same oncologists and a psychometric expert, which resulted in further minor changes. Revised health states were then piloted in a chained standard gamble (SG) interview followed by cognitive debrief. In the next phase of the study, each health state was valued by members of the general public (n=78) who completed a SG interview and a Visual Analogue Scale (VAS) rating. The health state ‘dead' was the lowest possible value fixed at 0. Quality of life (EQ-5D) and socio-demographic data were also collected. Data were summarised and investigated using analysis of variance.

RESULTS: The study sample was relatively well-matched to the general public in England and Wales (ONS, 2001). Mean SG utility scores were 0.70 (responding disease), 0.63 (stable disease, oral treatment), 0.58 (stable disease, IV treatment), 0.42 (progressive disease) and 0.33 (‘end of life'). SG values declined significantly from responding disease to ‘end of life', (F=32.14, P<0.0001). Mean VAS scores were 54.8 (responding disease), 41.1 (stable disease, oral treatment), 34.3 (stable disease, IV treatment), 20.4 (progressive disease) and 11.8 (‘end of life'). (F=98.08, P<0.0001).

CONCLUSIONS: This study captures the utility decrement associated with deteriorating metastatic lung cancer. These values could be used in a cost-utility analysis based on societal preferences. The study also identified a preference for oral therapy over IV therapy within the same disease stage.