338P - A conjoint analysis of willingness to pay to avoid metastatic breast cancer side effects
|Date||29 September 2012|
|Event||ESMO Congress 2012|
|Session||Poster presentation I|
|Topics|| Bioethics, Legal, and Economic Issues
Breast Cancer, Metastatic
D. Lalla1, M. Brammer2, R. Carlton3, T. Bramley3, A. D'Souza4
Patients with metastatic breast cancer (MBC) are treated with a variety of regimens with differing side effect profiles. In addition to efficacy, side effect profile can be an important consideration in therapy choice. Conjoint analysis is a research method used to evaluate how trade-offs are made between different attributes. This study assessed the willingness to pay (WTP) to avoid side effects related to MBC treatment using conjoint analysis. The WTP thus informs clinicians of patients' preferences and which side effects they are most desirous of avoiding.Methods
An online, self-administered survey of MBC patients in the US was conducted. The survey was fielded with a sample of adult female patients with a diagnosis of MBC. Key variables (attributes) included in the analysis and with levels described in lay terms were: Alopecia, Diarrhea, Fatigue, Pain, Nausea, Neuropathy, Neutropenia and Out of pocket costs. 15 scenarios (choice-based conjoint questions) were presented where patients selected the most preferred therapy. Each therapy was described with three distinct variables. The choices of variables for each therapy included two side effects and an out of pocket price. The survey also collected information on prior treatment regimens, previous side effect history, and demographics.Results
There were 298 responses. Most respondents were white (84%), married (57%) over 40 years of age (86%), and had private insurance (57%). MBC patients were willing to pay $3,894 to avoid severe diarrhea, $3,479 to avoid being hospitalized due to infection, $3,211 to avoid severe nausea, $2,764 to avoid severe tingling in hands and feet, $2,652 to avoid severe fatigue, $1,853 to avoid obvious hair loss and $1,458 to avoid severe pain. The most important attributes when selecting a therapy for MBC in terms of average utility were neutropenia, diarrhea and nausea.Conclusions
Patients most highly value the avoidance of diarrhea, neutropenia, and nausea with MBC treatment regimens. These are common side effects seen in many regimens used for treatment of MBC. This information can aid clinical decision making when selecting between MBC treatment options. Treatment regimens providing clinical efficacy while decreasing or eliminating key side effects would be an important choice to consider.Disclosure
D. Lalla: Dr. Lalla is an employee of Genentech, which funded this analysis.
M. Brammer: Dr. Brammer is an employee of Genentech, which funded this analysis.
R. Carlton: Dr. Carlton is an employee of Xcenda, which received funding from Genentech to conduct this analysis.
T. Bramley: Dr. Bramley is an employee of Xcenda, which received funding from Genentech to conduct this analysis.
A. D'Souza: Dr. D'Souza is an employee of Xcenda, which received funding from Genentech to conduct this anaysis.