Does framing of cancer survival affect perceived value of care? A willingness-to-pay survey of US residents

Abstract

Aims: To investigate the relationship between the framing of survival gains and the perceived value of cancer care. Methods: Through a population-based survey of 2040 US adults, respondents were randomized to one of the two sets of hypothetical scenarios, each of which described the survival benefit for a new treatment as either an increase in median survival time (median survival), or an increase in the probability of survival for a given length of time (landmark survival). Each respondent was presented with two randomly selected scenarios with different prognosis and survival improvements, and asked about their willingness to pay (WTP) for the new treatments. Results: Predicted WTP increased with survival benefits and respondents’ income, regardless of how survival benefits were described. Framing therapeutic benefits as improvements in landmark rather than median time survival increased the proportion of the population willing to pay for that gain by 11–35%, and the mean WTP amount by 42–72% in the scenarios we compared. Conclusion: How survival benefits are described may influence the value people place on cancer care.

Keywords::

• cancer
• contingent valuation
• patient decision-making
• risk communication
• risk perception
• willingness to pay

Acknowledgment

An abstract of this study was presented at the 2011 American Society of Clinical Oncology Annual Meeting, Chicago, IL, USA.

Financial and competing interests disclosure

This work was supported by a grant from Genentech to Tufts Medical Center. Publication was not contingent on Genentech’s approval. P-J Lin, T Concannon, J Cohen, H Auerbach, C-H Fang and P Neumann received research funding from Genentech. G Rossi and J Hille are or were employees of Genentech when this study was conducted and own stock in Roche, of which Genentech is a subsidiary. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.