Current debate on price setting and reimbursement of oncology drugs highlights the need to establish the value of oncology drugs. The aim of this study is to quantify societal preferences for oncology drugs with a discrete choice experiment in the Belgian population.
Six attributes with three levels each are selected based on literature review and focus group discussions with lay persons. The experimental design was generated using SAS 9.4 built-in capabilities. The final survey was sent to a random sample of 3,500 individuals in the Dutch speaking and French speaking community in Belgium. The preference of an average person was first estimated by a conditional logit model in SAS 9.4. Attributes were selected based on 0.05 significance level. Then, individual parameters are estimated with a mixed logit model using the R-package bayesm 3.0-2. Willingness to pay (WTP) was calculated taking into account interactions if appropriate.
Based on 961 respondents, societal value of oncology drugs is positively affected by a higher number of patients eligible for treatment, a high initial life expectancy and quality of life of patients, a high gain in quality of life and life expectancy due to the treatment and a low cost related to the treatment. The value of one point gain in quality of life, based on a 10-point scale, is however higher for patients with a low initial quality of life than for patients from which quality of life is less affected by the disease. The WTP of one year gain in life expectancy 3.55€, irrespective of the initial life expectancy. One year increase in life expectancy has the same value as one point increase in quality of life for a patient with an initial quality of life of 4/10. When the initial quality of life of the patient is higher than 4/10, one point gain in quality of life is worth less than one year gain in life expectancy. When the initial quality of life of the patient is lower than 4/10, one point gain in quality of life is worth more than one year gain in life expectancy.
The value of oncology drugs is context specific. Identification of valuable oncology drugs cannot be achieved by applying a “one size fits all principle”, which is now too often the case based on conventional instruments for market access of drugs.
Clinical trial identification
Legal entity responsible for the study
Flanders Innovation & Entrepreneurship + Reserach Foundation Flanders
All authors have declared no conflicts of interest.