Cost of cancer care: The impact of disclosure on willingness to pay and treatment preferences.

15 Background: Little is known about patients’ views regarding the costs of cancer care and its effect on treatment selection. Even less is known about how patients view information about conflicts of interest, such as disclosure of a clinic’s profit from cancer therapy. In the setting of health care reform and rising costs, we sought to understand how out-of-pocket costs and disclosure of profit impact patient treatment preferences. Methods: Previous breast cancer patients were invited to complete a web-based survey that presented four scenarios outlining cancer care treatment benefits and risks (MRI, pegfilgrastim, cold cap, and chemotherapy drugs). Initially, respondents were asked their preference for each treatment over a standard of care alternative and their out-of-pocket willingness to pay. After providing information about first, the total cost per treatment and second, the profit to the clinic, respondents were asked if their preference changed. Results: 40 women responded, all whom had previous diagnoses of breast cancer. In each of the four scenarios, respondents were less interested in the treatment option after being informed about cost or disclosure of a clinic profit. While 45.5% of respondents said they consider costs all or most of the time, only 9.1% considered clinic profit. However, 66.7% of respondents said they would be less interested in a treatment if they knew their provider received a profit from the treatment. Conclusions: Patients are less likely to prefer treatments after disclosure of total cost and clinic profit data. Communication about the costs and profits associated with cancer care may be an essential component of informed decision making in an era of growing patient involvement and escalating health care costs. [Table: see text]