Patients’ involvement in the health technology assessment (HTA) decision-making process is important for transparency, legitimacy and fairness. The study objectives were to understand breast cancer patients’ perspectives when choosing their treatment, highlight treatment characteristics valued as most important by patients and gain information on patients’ trade-offs between available treatments.
A discrete choice experiment survey of breast cancer patients was conducted in Spain, Poland, France and Ireland. The survey design included: literature review, qualitative research, cognitive debriefing, data collection and analysis. A panel of experts from participating countries (physicians, patient group representatives, ex-payers) selected the survey treatment attributes: progression-free survival (PFS), febrile neutropenia (FN), pain, functional well-being (FWB) and out-of-pocket payment (OPP). Patients selected (or opted-out) between two unlabelled hypothetical treatments containing the previously mentioned five attributes. Panels of breast cancer patients were recruited as respondents and the questionnaire was deployed through a website platform. A D-efficient experimental design with 16 choice-sets was constructed and a conditional logistic model was used to estimate patients’ preferences. Marginal rates of substitution (MRS) was used to estimate out-of-pocket payments.
In total, 317 breast cancer patients completed the survey. FWB and pain were the most important attributes chosen by patients. Respondents were willing to pay €17,288 out-of-pocket to move from severe to no impairment in FWB, followed by moderate impairment (€15,297) and from severe pain to no pain state (€15,138). Patients would pay €574 annually for one additional PFS month. Preferences differed by age for FN and FWB; highly educated patients have stronger preference for PFS compared to non-highly educated.
Breast cancer treatments that improve pain, FWB and PFS are considered preferred treatments from patients’ perspective.
Novartis Oncology Region Europe.
Novartis Oncology Region Europe.
T. Konstantopoulou: Full / Part-time employment: Novartis Oncology. E. Stamuli: Research grant / Funding (institution): Novartis Oncology Region Europe. D. Ross: Advisory / Consultancy: Novartis Oncology Region Europe. R. Pacheco: Full / Part-time employment: Novartis Oncology Region Europe.