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.