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A cost-benefit, willingness-to-pay analysis of the preventive pharmacological antiemetic treatment in cancer patients receiving chemotherapy

By Μαρία Σπινθούρη


Background: One of the most significant breakthroughs in this decade that has had a major impact on patient quality of life has been the development of the 5-HT3 receptor antiemetic agents. Following their wide spread adoption, the complete control of acute emesis following cisplatin-based chemotherapy was increased to approximately 70%. However, despite the use of 5-HT3s beyond the first 24 hours, up to 50% of patients still suffer from delayed emesis. The NK1 receptor antagonists are new class of antiemetic agents under investigation, which are designed to reduce the incidence of acute and delayed emesis. Early data from double blind randomized phase II trials suggest that an orally administered NK1 (Hesketh et al. 1999) can improve acute and delayed emesis control following cisplatin by 20% and 30% respectively. Objective: To measure the value that cancer patients place on improved emesis control and quality of life. Design: A consumer based Willingness-to-Pay (WTP) analysis Patients: 65 cancer patients from Greece receiving cisplatin-based chemotherapy or had received cisplatin-based chemotherapy for the past six months. Methods: After background information on the risk of emesis and on the new NK1s were presented, patients were asked the maximum that they would be willing to pay per day for a drug that reduced their risk of acute and delayed emesis (up to day 5) by 20% and 30% respectively. The cost unit was the Euro 2002 exchange rate. Results: For a 20% improvement in acute emesis control, Greek cancer patients were willing to pay €13.68. In the case of a 30% improvement in delayed emesis control cancer patients were willing to pay €12.86. Conclusions: The results suggest that there are substantial socio-economic and cultural differences in how cancer patients value benefit and improved quality of life thus it may be a need to reevaluate our perceived level of patient benefit and measures of quality of life.

Topics: Ανάλυση κόστους οφελειών, Μελέτη ενδεχόμενης αποτίμησης, Πρόθεση πληρωμής, Αντιεμετική αγωγή, Αντιεμετικά φάρμακα, Χημειοθεραπεία, Σισπλατίνη, Κόστος, Όφελος, Καρκίνος, Ναυτία, Εμετός, Cost-benefit analysis, Contigent valuation study, Willingness to pay, Antiemetic therapy, Antiemetic drugs, Chemotherapy, Cisplatin, Cost, Benefit, Cancer, Nausia, Emesis
Publisher: National and Kapodistrian University of Athens
Year: 2003
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