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Gepubliceerd in:

11-12-2023

QALY-type preference and willingness-to-pay among end-of-life patients with cancer treatments: a pilot study using discrete choice experiment

Auteurs: Yue Yin, Qian Peng, Longhao Ma, Yi Dong, Yinan Sun, Silu Xu, Nianyang Ding, Xiaolin Liu, Mingye Zhao, Yaqian Tang, Zhiqing Mei, Hanqiao Shao, Dan Yan, Wenxi Tang

Gepubliceerd in: Quality of Life Research | Uitgave 3/2024

Abstract

Purpose

Quality-adjusted life-year (QALY) is a dominant measurement of health gain in economic evaluations for pricing drugs. However, end-of-life (EoL) patients’ preference for QALY gains in life expectancy (LE) and quality of life (QoL) during different disease stages remains unknown and is seldom involved in decision-making. This study aims to measure preferences and willingness-to-pay (WTP) towards different types of QALY gain among EoL cancer patients.

Methods

We attributed QALY gain to four types, gain in LE and QoL, respectively, and during both progression-free survival (PFS) and post-progression survival (PPS).

A discrete choice experiment including five attributes (the four QALY attributes and one cost attribute) with three levels each was developed and conducted with 85 Chinese advanced non-small cell lung cancer patients in 2022. All levels were set with QALY gain/cost synthesised from research on anti-lung cancer drugs recently listed by Chinese National Healthcare Security Administration. Each respondent answered six choice tasks in a face-to-face interview. The data were analysed using mixed logit models.

Results

Patients valued LE-related QALY gain in PFS most, with a relative importance of 81.8% and a WTP of $43,160 [95% CI 26,751 ~ 59,569] per QALY gain. Respondents consistently preferred LE-related to QoL-related QALY gain regardless of disease stage. Patients with higher income or lower education levels tended to pay more for QoL-related QALY gain.

Conclusion

Our findings suggest a prioritised resource allocation to EoL-prolonging health technologies. Given the small sample size and large individual heterogeneity, a full-scale study is needed to provide more robust results.

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Titel: QALY-type preference and willingness-to-pay among end-of-life patients with cancer treatments: a pilot study using discrete choice experiment
Auteurs: Yue Yin
Qian Peng
Longhao Ma
Yi Dong
Yinan Sun
Silu Xu
Nianyang Ding
Xiaolin Liu
Mingye Zhao
Yaqian Tang
Zhiqing Mei
Hanqiao Shao
Dan Yan
Wenxi Tang
Publicatiedatum: 11-12-2023
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 3/2024
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-023-03562-3

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