Patient Preferences for Metastatic Colorectal Cancer Treatment: A Multi-method Approach Using Discrete Choice...

Area of Science:

• Oncology
• Health Economics
• Patient-Reported Outcomes

Background:

• Metastatic colorectal cancer (mCRC) treatment decisions involve balancing survival, quality of life (HRQoL), and side effects.
• Quantitative patient preferences are crucial but not yet integrated into health technology assessments (HTAs) for drug reimbursement.

Purpose of the Study:

• To explore incorporating quantitative patient preferences into cancer treatment HTA decision-making.
• To elicit treatment preferences and risk tolerance of mCRC patients in Canada using a multi-method approach.

Main Methods:

• Developed a survey with discrete choice experiments (DCEs) and best-worst scaling (BWS-1).
• DCEs assessed preferences for HRQoL, survival, administration, frequency, and side effects.
• BWS-1 evaluated tolerance for 25 potential mCRC treatment side effects.
• Survey administered to 127 mCRC patients across Canada; data analyzed using mixed logit, latent class, and count-based models.

Main Results:

• Patients valued overall survival and HRQoL almost equally.
• Preferred better outcomes (longer progression-free survival, no side effects) over worse outcomes.
• Expressed disutility for oral capsules compared to intravenous infusions.
• Significant preference heterogeneity observed based on patient experiences and health status.
• Most tolerable side effects included fatigue and activity limitations; least tolerable included severe symptoms like vomiting and pain requiring assistance.

Conclusions:

• A multi-method approach effectively assesses patient preferences and risk tolerance in mCRC.
• Findings provide a robust foundation for integrating patient perspectives into Canada's HTA framework.
• Results will inform future efforts to incorporate patient preferences into cancer treatment HTA decision-making.