Population preference values for health states in relapsed or refractory B-precursor acute lymphoblastic leukemia in the United Kingdom

Health state descriptions. (DOCX 41 kb

Out of hours: an evaluation of the continuing community cancer care program in western Sydney, CHERE Discussion Paper No 20

The domiciliary after hours nursing service (AHNS) of the 4C program in Western Sydney is registering approximately 550 people per year. In this discussion paper, the results of an evaluation of the AHNS are reported. The service caters for clients with a variety of needs, providing emotional support as well as physical nursing care. Carer satisfaction with the service is high. The availability of the service alone (irrespective of whether it is used) is a source of satisfaction for many carers. However, the service has not succeeded in reducing admissions to hospital or length of stay. The cost of the program is therefore only partially offset by savings in hospital resources. Only a small reduction in hospital use is needed to make the 4C program cost neutral. It is expected that a new drugs policy, allowing better out-of-hours access to pain killing drugs will improve the effectiveness of the service and its efficiency.Domiciliary care, cancer, evaluation

Conjoint Analysis of a New Chemotherapy: Willingness to Pay and Preference for the Features of Raltitrexed versus Standard Therapy in Advanced Colorectal Cancer

Objective: To estimate the willingness to pay for a new chemotherapy, raltitrexed (Tomudex(TM) ) over conventional therapy with fluorouracil plus leucovorin (FU-LV) from the perspective of patients with advanced colorectal cancer. The study was part of the product's reimbursement application in Australia. Design and Methods: The key differences relevant to patients between the two therapies, frequency of administration and severity of mouth ulceration, were used to develop a self-administered questionnaire. A relatively new technique to healthcare, that of conjoint analysis (CA), was used to estimate willingness to pay and strength of preference. A discrete choice CA was used. Analysis was via a logit model with adjustment for the cluster effect (or intra-patient correlation). Study participants: Oncology nurses served as proxies for patients with advanced colorectal cancer. Results: The participation rate was 87% (62/71) with questionnaires from 56 respondents eligible for analysis. The CA method generated a mean incremental willingness to pay of 745 Australian dollars ($A;$US507) per cycle of chemotherapy, comprising $A550 ($US374) and $A195 ($US133) for the toxicity and administration improvements, respectively (1998 values). Both features were related to preference with independent odds of 6.87 and 1.98, respectively, however only the toxicity attribute was a significantly related to preference. Subscription to private health insurance was the only significant demographic predictor identified, however, the homogeneous income structure of the respondents seems likely to have masked any significant income effect. Conclusions: This study highlights the advantages of using CA in healthcare, where new therapies or treatments are often composed of a number of attributes. The CA allows both strength of preference and willingness to pay for individual treatment attributes to be estimated and can be used to assign statistical significance to these parameters.Antineoplastics, Colorectal cancer, Fluorouracil, Folinic acid, Pharmacoeconomics, Raltitrexed, Willingness to pay

Additional file 2: of Population preference values for health states in relapsed or refractory B-precursor acute lymphoblastic leukemia in the United Kingdom

Survey instrument: time trade-off exercise. (DOCX 58 kb

Preface to the Workshop on Mining Communities and People Recommenders

Presents the welcome message from the conference proceeding