Health utility scores of colorectal cancer based on societal preference in Japan Takeru Shiroiwa Æ Takashi Fukuda Æ Kiichiro Tsutani Accepted: 6 July 2009 / Published online: 21 July 2009 Ó Springer Science+Business Media B.V. 2009 Abstract Purpose We measured health utility scores of colorectal cancer (CRC) patients from a societal perspective in Japan. Methods Twenty-five states of health were described: four metastatic states without severe adverse events (AEs), 16 metastatic states with Grade 3/4 AEs, four adjuvant states, and one terminal state. A total of 1,500 respondents stratified by age and gender were recruited randomly from the largest Web-panel in Japan. Respondents were allo- cated randomly to three of the 25 health states and answered questionnaires by standard gamble (SG) and time trade-off (TTO) methods. Results Although utility scores of metastatic CRC receiving XELOX (capecitabine plus oxaliplatin) chemo- therapy were 0.48(SG and TTO) (with stoma) and 0.57(SG) or 0.59(TTO) (without stoma), utility scores of those receiving FOLFOX4 (5-fluorouracil/folinic acid and oxaliplatin) chemotherapy were 0.42(SG) or 0.43(TTO) (with stoma) and 0.52(SG) or 0.53(TTO) (without stoma). These differences between XELOX and FOLFOX4 were statistically significant (P = 0.0198 in SG and P = 0.0059 in TTO). Stage 3/4 AEs decreased utility scores to 0.35–0.4 and 0.4–0.45 in the presence and absence of stoma, respectively. Conclusions XELOX was generally considered a signif- icantly preferable chemotherapy regimen compared to FOLFOX4 for CRC in Japan. Almost all Grade 3/4 AEs and stoma significantly decreased utility scores. These differences are dependent on the accuracy of the health state description and to confirm these results. In future research, it would be preferable that preference-based HRQoL measures are used directly in patients if utility scores are practically measurable by such method. Keywords Colorectal neoplasms  Quality-adjusted life-years  FOLFOX  XELOX  Standard gamble  Time trade-off Abbreviations CRC Colorectal cancer MCRC Metastatic colorectal cancer AEs Adverse events FOLFOX 5-Fluorouracil/folinic acid and oxaliplatin XELOX Capecitabine (Xeloda Ò ) plus oxaliplatin SG Standard gamble TTO Time trade-off HS Health state Introduction Colorectal cancer (CRC) is the third leading cause of death in Japan due to malignant neoplasms after lung and stomach cancer [1]. Each year in Japan 40,000 people die from CRC. Moreover, the age-adjusted incidence rate of CRC is *52 per 100,000 people in 2001, representing the second highest incidence rate for a malignant neoplasm after stomach cancer [2]. Systematic chemotherapy can delay the progression of metastatic CRC (MCRC) and prolong survival time. In the T. Shiroiwa (&)  K. Tsutani Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan e-mail: t.shiroiwa@gmail.com T. Fukuda Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, Tokyo, Japan 123 Qual Life Res (2009) 18:1095–1103 DOI 10.1007/s11136-009-9513-z