Melanoma quality of life: pilot study using utility measurements.

Q uality of life (QOL) is an important predictor of melanoma survival and thus important to understand. Utilities are a health economic measure of QOL eliciting patient preferences for a specific health state. Patients theoretically give up something of value (money, time, risk of death) to not have the disease in question, thus providing insight into the burden of disease. In an era of limited economic resources and with an annual direct cost of over $563 million, the effectiveness of melanoma therapy, in terms of survival and QOL, is a vital criterion for setting priorities in health care. Utilities are used to adjust the amount of life extended by therapeutic interventions investigated in cost-effectiveness analyses (CEAs). Currently, no repository of melanoma utility data by stage exists. Our goal was to fill this void and test face validity, comparing utilities across stage and time. We hypothesized that melanoma utilities would decrease (more QOL impact) with increasing stage of disease and that time from initial diagnosis would temper the QOL impact as reflected in increased utilities. Finally, because some researchers use proxy subjects to estimate utilities, we explore the ability of our subjects to estimate the impact of melanoma at stages other than their own.