TY - JOUR
T1 - To tell or not to tell
T2 - The community wants to know about expensive anticancer drugs as a potential treatment option
AU - Mileshkin, Linda
AU - Schofield, Penelope E.
AU - Jefford, Michael
AU - Agalianos, Emilia
AU - Levine, Michele
AU - Herschtal, Alan
AU - Savulescu, Julian
AU - Thomson, Jacqui Ann
AU - Zalcberg, John R.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Purpose: Many new cancer treatments are available only at significant financial cost to the patient. We previously reported that Australian medical oncologists commonly do not discuss unsubsidized, expensive anticancer drugs (EACD) because of concern about causing distress. We argued that this position was not consistent with modern ethical principals but wanted to seek the community viewpoint. Methods: A cross-sectional telephone survey of the Australian general public was performed. Respondents' views were sought about three hypothetical scenarios in which they were diagnosed with incurable cancer and an EACD treatment (out-of-pocket cost US$25,000) was available. Results: Responses were obtained from 1,255 respondents (response rate, 43%). One hundred thirtyseven (11%) had a prior cancer diagnosis. Ninety-one percent of respondents wanted to be told by their doctor about an EACD that could improve survival by an additional 4 to 6 months, with 51% prepared to pay for it. People were more willing to pay if the drug could improve quality of life (71%) or if there was no effective standard treatment (76%). Sixty-eight percent believed the government should pay. Cost would be a significant financial burden for 31% of those willing to pay. Those more likely to want to be informed were younger, employed, better-educated, or had higher income levels (P < .05). Responses did not vary with the person's personal experience of cancer. Of the 9% who did not wish to be informed, half of these were concerned about the information causing distress. Conclusion: The Australian general public wants to be informed about EACD as potential treatment options, even if they are not willing or readily able to pay for them.
AB - Purpose: Many new cancer treatments are available only at significant financial cost to the patient. We previously reported that Australian medical oncologists commonly do not discuss unsubsidized, expensive anticancer drugs (EACD) because of concern about causing distress. We argued that this position was not consistent with modern ethical principals but wanted to seek the community viewpoint. Methods: A cross-sectional telephone survey of the Australian general public was performed. Respondents' views were sought about three hypothetical scenarios in which they were diagnosed with incurable cancer and an EACD treatment (out-of-pocket cost US$25,000) was available. Results: Responses were obtained from 1,255 respondents (response rate, 43%). One hundred thirtyseven (11%) had a prior cancer diagnosis. Ninety-one percent of respondents wanted to be told by their doctor about an EACD that could improve survival by an additional 4 to 6 months, with 51% prepared to pay for it. People were more willing to pay if the drug could improve quality of life (71%) or if there was no effective standard treatment (76%). Sixty-eight percent believed the government should pay. Cost would be a significant financial burden for 31% of those willing to pay. Those more likely to want to be informed were younger, employed, better-educated, or had higher income levels (P < .05). Responses did not vary with the person's personal experience of cancer. Of the 9% who did not wish to be informed, half of these were concerned about the information causing distress. Conclusion: The Australian general public wants to be informed about EACD as potential treatment options, even if they are not willing or readily able to pay for them.
UR - http://www.scopus.com/inward/record.url?scp=73349096027&partnerID=8YFLogxK
U2 - 10.1200/JCO.2009.22.7793
DO - 10.1200/JCO.2009.22.7793
M3 - Article
C2 - 19786663
AN - SCOPUS:73349096027
SN - 0732-183X
VL - 27
SP - 5830
EP - 5837
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 34
ER -