Examining the Association Between Equity-Related Factors and EQ-5D-3L Health Utilities of Patients with Cancer.

BACKGROUND: EQ-5D-3L health utilities inform health technology assessments in oncology, often derived from clinical trials enrolling highly selected populations, which may over-estimate real-world health utilities. Little is known about the association between socioeconomic status (SES) and EQ-5D-3L health utilities. Our objective was to examine EQ-5D-3L health utilities across SES in a real-world sample of patients with cancer. METHODS: We conducted a cross-sectional analysis of EQ-5D-3L responses from 170 adult patients with cancer accrued from an Ontario oncology centre. We fitted multivariable linear regression models to estimate associations between covariates and EQ-5D-3L health utilities. RESULTS: Lower EQ-5D-3L health utilities were significantly associated with the lowest and undisclosed family income categories in models with and without birth sex (p < 0.05). In the model including birth sex, disutility estimates for lowest family income (<CAD 29K) and undisclosed income was -0.202, 95% CI (-0.371 to -0.033), and -0.123 (-0.235 to -0.012), respectively. For the model excluding birth sex, disutility estimates for lowest income and undisclosed income was -0.163 (-0.280 to -0.046) and -0.106 (-0.184 to -0.028). CONCLUSIONS: Lower EQ-5D-3L health utilities were significantly associated with low income and nondisclosure, highlighting the need to incorporate SES in analyzing health utilities in cancer care.