Patient Preferences For Chemotherapy In The Treatment Of Non-Small Cell Lung Cancer: A Multicenter Discrete Choice Experiment (DCE) Study In China

Figures & data

Table 1 Attributes And Their Levels

Attributes	Levels
Progression free survival	11 months
	8 months
	5 months^a
Disease control rate	High, 90%
	Middle, 75%
	Low, 60%^a
Rash	None, no rash
	Moderate, rash covers less than 10% of your body
	Severe, rash covers more than 1/3 of your body^a
Nausea and vomiting	Mild, once a day
	Moderate, 2 to 5 times a day
	Severe, more than 6 times a day^a
Tiredness	Mild, daily activities little influenced, some difficulties on exercising, climbing several flights of stairs, or running
	Moderate, daily activities somewhat influenced, some difficulties on shopping, house working, travelling
	Severe, daily activities severely influenced, you do not have the energy to get out of bed^a
Out-of-pocket costs	CN¥50,000/month
	CN¥25,000/month
	CN¥10,000/month^a
Administration mode	Infusion
	Oral^a

Note: ^aReference level.

Abbreviation: CN, Chinese yuan.

Figure 1 Sample of DCE survey question.

Table 2 Demographic Characteristics Of The Study Sample

Characteristics	Subjects N=361
Gender – No.(%)
Male	228(63)
Female	133(37)
Age – Years
Mean	58
Range	31–82
Education – No.(%)
Less than high school	176(49)
High school	91(25)
Bachelor’s degree or higher	94(26)
Family Per Capita Income < Per Capita GDP In 2016	151(42)
Cancer Type – No.(%)
Adenocarcinoma	223(62)
Squamous cell carcinoma	118(33)
Large cell carcinoma	20(5)
Cancer Stage – No.(%)
Stages I, II	102(28)
Stage III	131(36)
Stage IV	128(35)
Time Since Diagnosis – No.(%)
Less than 1 year	266(74)
1 year or more	95(26)
Treatments Received – No.(%)^a
Chemotherapy	361(100)
Surgery	142(39)
Radiation	66(18)
Other	14(4)

Note: ^aPatients could have more than one treatment.

Abbreviation: GDP, gross domestic product.

Table 3 Main Effects Mixed Parameter Logit Model Results

Attributes	Coefficient^a	SE	P Value	95% CI
				LB	HB
Progression Free Survival
11 months	0.59	0.05	0.00	0.49	0.69
8 months	0.11	0.03	0.00	0.04	0.17
5 months	−0.70	0.06	0.00	−0.80	−0.59
Disease Control Rate
High (90%)	0.37	0.04	0.00	0.29	0.45
Middle (75%)	−0.15	0.03	0.00	−0.21	−0.09
Low (60%)	−0.22	0.04	0.00	−0.30	−0.14
Rash
None	−0.01	0.03	0.65	−0.08	0.05
Moderate	0.04	0.03	0.23	−0.02	0.05
Severe	−0.02	0.03	0.51	−0.09	0.04
Nausea and Vomiting
Mild	0.11	0.03	0.00	0.05	0.18
Moderate	0.02	0.03	0.54	−0.04	0.08
Severe	−0.13	0.04	0.00	−0.20	−0.06
Tiredness
Mild	0.22	0.04	0.00	0.15	0.29
Moderate	0.07	0.03	0.03	0.01	0.13
Severe	−0.29	0.04	0.00	−0.36	−0.22
Administration Mode
Infusion	−0.05	0.02	0.03	−0.09	−0.01
Oral	0.05	0.02	0.03	0.01	0.09
Costs, CN¥	−0.04	0.00	0.00	−0.04	−0.03

Note: ^aCoefficients represent the change in utility for a respondent for a specific level of a given attribute.

Abbreviations: SE, standard error; CI, confidence interval; CN, Chinese yuan; LB, low bound; HB, high bound.

Figure 2 Patient preferences intensity.

Table 4 Variation In Patient Preferences For NSCLC Treatment

Attributes	Coefficient^a	SE	P Value
Aged 30–40 × 8 month of PFS	0.11	0.08	0.01
Aged 40–69 × None rash	0.10	0.05	0.04
Aged 30–40 × Infusion mode	−0.12	0.06	0.03
Squamous cell carcinoma × None rash	0.13	0.04	0.01
Adenocarcinoma × Mild tiredness	0.21	0.05	0.01
Stage I × 11 month of PFS	−0.23	0.11	0.01
Stage II × 11 month of PFS	−0.12	0.09	0.04
Stage III × 11 month of PFS	0.15	0.07	0.01

Note: ^aCoefficients show estimated utility of each attribute, where positive coefficients indicate positive preference. Positive coefficients for aged 30–40 × <attribute> interaction terms indicate that group aged 30–40 place higher preference on that attribute than other age group.

Abbreviation: SE, standard error.

Table 5 Patients’ Marginal WTP For Each Attribute Level

Attributes	WTP^a,b (95% CI), Average $ Per Month
	Value	LB	HB
Progression-Free Survival
11 months	2340	1927	3754
8 months	424	172	675
5 months	−3764	−3193	−2335
Disease Control Rate
High (90%)	1465	1163	1767
Middle (75%)	−587	−826	−348
Low (60%)	−878	−1183	−573
Rash
None	−56	−299	186
Moderate	145	−90	381
Severe	−89	−353	175
Nausea and Vomiting
Mild	452	189	716
Moderate	74	−160	308
Severe	−526	−800	−253
Tiredness
Mild	879	600	1159
Moderate	269	29	508
Severe	−1148	−1444	−853
Administration Mode
Infusion	−195	−368	−22
Oral	195	22	368

Notes: ^aWillingness to pay calculations are mean estimates derived from mixed logit model without interactions. ^bNegative values represent the average amount of cost that would have to be decreased for a patient to choose a treatment with that characteristic.

Abbreviations: SE, standard error, WTP, willingness to pay. CI, confidence interval, CN, Chinese yuan.