PCR38 Preferences and Willingness-to-Pay for Quality of Life Outcomes in Advanced Cancer Patients: A Discrete Choice Experiment

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Cancer patients are often found to have different preferences in decision-making from their family members or healthcare providers. This longitudinal study aims to quantify advanced cancer patient’s preferences and their willingness-to-pay (WTP) for different quality of life (QoL) outcomes using a discrete choice experiment (DCE).
The DCE was developed with seven QoL attributes, identified from literature and expert consultation, including physical, emotional, and social dysfunction, severity of pain, place of death, expected length of survival, and monthly out-of-pocket (OOP) medical payment. The choice-sets were based on D-efficient design, with no opt-out option. Respondents were advanced cancer patients recruited from two major public hospitals in Malaysia. Each respondent was asked to answer 16 choice-sets. Dummy-coded data was then analysed using conditional logistic regression to estimate the coefficient of each attribute and their marginal WTP. Respondents will be followed up after three months to readminister the choice-sets to explore changes of their preferences. In-depth interviews were also conducted to better understand their perceived needs and decision-making process.
Preliminary results were obtained from 14 advanced cancer patients. All attributes were statistically significant (p<0.05) and their coefficient values followed a priori expectation, except for physical and social dysfunction. Current analysis showed that survival and emotional functioning were the most valued among all attributes, with OOP WTP of US$755/month (95% CI: 380, 1130) for one additional year of survival and US$677/month (95% CI: 271, 1083) to improve emotional dysfunction from severe to mild. Most of the respondents (9/14, 64%) were newly diagnosed (within 3 months) with advanced cancer. The preliminary results highlight the importance of survival and emotional state during the early period after diagnosis. The in-depth interviews also corroborated the preliminary results.
Advanced cancer patients weighed survival benefit and emotional functioning relatively higher during the early period after diagnosis.
Original languageEnglish
Pages (from-to)S548
Number of pages1
JournalValue in Health
Issue number7 Supplement
Publication statusPublished - 1 Jul 2022
EventISPOR 2022: The Future of HEOR in Patient-Driven Digital Healthcare Systems -
Duration: 15 May 202218 May 2022
https://www.sciencedirect.com/journal/value-in-health/vol/25/issue/7/suppl/S (Published Abstracts)

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