scholarly journals Patient preferences for breast cancer treatments: A discrete choice experiment from four European countries

2019 ◽  
Vol 30 ◽  
pp. v135
Author(s):  
T. Konstantopoulou ◽  
E. Stamuli ◽  
D. Ross ◽  
R. Pacheco
2020 ◽  
Vol 5 (1) ◽  
pp. 238146832092801
Author(s):  
Ilene L. Hollin ◽  
Juan Marcos González ◽  
Lisabeth Buelt ◽  
Michael Ciarametaro ◽  
Robert W. Dubois

Purpose. Assess patient preferences for aspects of breast cancer treatments to evaluate and inform the usual assumptions in scoring rubrics for value frameworks. Methods. A discrete-choice experiment (DCE) was designed and implemented to collect quantitative evidence on preferences from 100 adult female patients with a self-reported physician diagnosis of stage 3 or stage 4 breast cancer. Respondents were asked to evaluate some of the treatment aspects currently considered in value frameworks. Respondents’ choices were analyzed using logit-based regression models that produced preference weights for each treatment aspect considered. Aggregate- and individual-level preferences were used to assess the relative importance of treatment aspects and their variability across respondents. Results. As expected, better clinical outcomes were associated with higher preference weights. While life extensions with treatment were considered to be most important, respondents assigned great value to out-of-pocket cost of treatment, treatment route of administration, and the availability of reliable tests to help gauge treatment efficacy. Two respondent classes were identified in the sample. Differences in class-specific preferences were primarily associated with route of administration, out-of-pocket treatment cost, and the availability of a test to gauge treatment efficacy. Only patient cancer stage was found to be correlated with class assignment ( P = 0.035). Given the distribution of individual-level preference estimates, preference for survival benefits are unlikely to be adequately described with two sets of preference weights. Conclusions. Although value frameworks are an important step in the systematic evaluation of medications in the context of a complex treatment landscape, the frameworks are still largely driven by expert judgment. Our results illustrate issues with this approach as patient preferences can be heterogeneous and different from the scoring weights currently provided by the frameworks.


2010 ◽  
Vol 49 (3) ◽  
pp. 328-337 ◽  
Author(s):  
Merel L. Kimman ◽  
Benedict G. C. Dellaert ◽  
Liesbeth J. Boersma ◽  
Philippe Lambin ◽  
Carmen D. Dirksen

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17509-e17509 ◽  
Author(s):  
Phaedra Johnson ◽  
Tim Bancroft ◽  
Richard L. Barron ◽  
Jason C. Legg ◽  
Xiaoyan Li ◽  
...  

e17509 Background: As patient-centered care becomes more prominent, a better understanding of patient preferences and tradeoffs amongst treatment alternatives and outcomes is needed. This study used a discrete choice experiment to examine the preferences and willingness to pay for prophylactic G-CSF to decrease the incidence of chemotherapy (CT)-induced febrile neutropenia in breast cancer patients who previously received CT. Methods: An online survey was developed with 16 paired treatment choice scenarios comparing 3 alternative G-CSF options (11 versus 1 or 6 versus 1 injections per CT cycle) with a follow-up “no treatment” option. Each scenario had 4 attributes: risk of disruption to CT schedule due to neutropenia, risk of infection requiring hospitalization, frequency of G-CSF administration, and total out-of-pocket (OOP) cost for G-CSF during a CT cycle. Patients’ preferences and willingness to pay (as OOP cost) were estimated using logistic regression. Results: Patients’ (n = 296) preferred G-CSF options with the lowest OOP costs, the fewest injections, and improved outcomes (lowest risk of disruption to CT schedule and lowest risk of infection requiring hospitalization). In the context of this discrete choice experiment, OOP costs and risk of disruption to CT schedule were the most important attributes to patients; risk of infection requiring hospitalization and frequency of G-CSF administration affected patients’ choice of G-CSF option to a smaller but similar degree. Patients were willing to pay OOP $1,076 per cycle to reduce the risk of disrupting the CT schedule from high to low, $884 per cycle to reduce the risk of developing an infection requiring hospitalization from 24% (high) to 7% (low), and $851 and $667 per cycle to decrease the number of G-CSF injections per cycle from 11 to 1 and 6 to 1, respectively. Conclusions: With a current focus on patient-centered approaches in decision-making, physicians need to consider patient preferences when making decisions about therapy, including supportive care agents.


2021 ◽  
pp. 1357633X2110228
Author(s):  
Centaine L Snoswell ◽  
Anthony C Smith ◽  
Matthew Page ◽  
Liam J Caffery

Introduction Telehealth has been shown to improve access to care, reduce personal expenses and reduce the need for travel. Despite these benefits, patients may be less inclined to seek a telehealth service, if they consider it inferior to an in-person encounter. The aims of this study were to identify patient preferences for attributes of a healthcare service and to quantify the value of these attributes. Methods We surveyed patients who had taken an outpatient telehealth consult in the previous year using a survey that included a discrete choice experiment. We investigated patient preferences for attributes of healthcare delivery and their willingness to pay for out-of-pocket costs. Results Patients ( n = 62) preferred to have a consultation, regardless of type, than no consultation at all. Patients preferred healthcare services with lower out-of-pocket costs, higher levels of perceived benefit and less time away from usual activities ( p < 0.008). Most patients preferred specialist care over in-person general practitioner care. Their order of preference to obtain specialist care was a videoconsultation into the patient’s local general practitioner practice or hospital ( p < 0.003), a videoconsultation into the home, and finally travelling for in-person appointment. Patients were willing to pay out-of-pocket costs for attributes they valued: to be seen by a specialist over videoconference ($129) and to reduce time away from usual activities ($160). Conclusion Patients value specialist care, lower out-of-pocket costs and less time away from usual activities. Telehealth is more likely than in-person care to cater to these preferences in many instances.


Sign in / Sign up

Export Citation Format

Share Document