Longitudinal Changes in Health Utility Scores During the Perioperative Period Among Patients With Oral Cancer: An Analysis of the Effect of Older Age and Social Background

OBJECTIVE: Many countries have implemented health technology assessment of their public medical insurance programs owing to rising social security costs from ageing populations and expensive emerging medical technologies. Clarifying factors that affect health utility scores is essential for implementing treatments that reflect social values. Therefore, this prospective, observational study aimed to investigate the longitudinal changes in the health utility scores of patients with oral cancer eligible for radical treatment perioperatively. METHODS: Overall, 219 patients with oral cancer who received standard therapy and completed utility assessments using the EQ-5D-5L at treatment completion and at 1, 3, 6 months, and 1 year post-treatment were evaluated. Longitudinal changes in utility scores and factors influencing these scores were analysed. RESULTS: The 1-year post-treatment utility scores were significantly higher than those before treatment (p < 0.01). Utility scores did not differ significantly between older and non-older patients at all assessment time-points. Marital status significantly influenced utility scores. Furthermore, utility scores did not differ significantly according to employment or living conditions. CONCLUSIONS: Health utility disadvantages are not associated with standard treatment for older patients with oral cancer, provided that they have good physical and cognitive functions. Additionally, considering social support for unmarried patients with cancer is vital.