https://orcid.org/0000-0002-3086-1210
Abstract
Introduction
The different alternatives for non-small-cell lung cancer (NSCLC) treatment can increase survival but cause important adverse events. Therefore, patients’ preference can play a critical role in decision-making. Among stated preference methods, discrete choice experiment (DCE) is the most applied in health care to elicit preferences. This research aims to elicit patients’ preference evaluating the trade-off between the risks (adverse events) and benefits (survival) of systemic treatments, from the perspective of Brazilian patients with locally advanced, metastatic or recurrent NSCLC.
Methods
A DCE was performed following the steps of attributes selection; construction of tasks and respondents’ preference elicitation. Patients chose between 2 hypothetical treatments described by the attributes tiredness, hair loss, skin rash, hospitalization, administration mode and survival. A paper-and-pencil survey method was used to elicit the answers from the participants. The statistical data analysis used a mixed logit model to predict the relative importance of the attributes.
Results
Most of the 65 patients interviewed were men (53.8%), mean age of 65 (95% confidence interval [CI]: 63–67) years and lung cancer stage IV (67.7%). Except for hospitalization and administration mode, the attributes coefficients were statistically significant (p < 0.005) for patients’ preferences. Patients would require a minimum survival gain of 11.72 (CI: 10.28–4.22) months and 19.72 (CI: 17.31‐7.09) months to accept a treatment that causes severe tiredness and severe skin rash, respectively. The market share of the treatments was calculated according to the DCE aggregate-level estimation, considering the impact of each treatment’s side effects. Paclitaxel plus carboplatin had an estimated market share of 31%, followed by gefitinib (27%), erlotinib (24%) and docetaxel (18%).
Conclusion
In general, less than a year of survival gain would not suffice for the appearance of severe skin rash or tiredness.
Acknowledgments
We would like to thank the members of Health Technology Assessment Groups from Instituto Nacional de Cardiologia and from Instituto Nacional de Câncer, as well as, Instituto Nacional de Câncer staff for research support.
Disclosure
The abstract of this paper was presented at the Virtual ISPOR Conference 2020 as a poster presentation with interim findings. The authors report no conflicts of interest in this work.