ACORN Research, LLC , Memphis, TN , USA.
J Med Econ. 2013 Oct;16(10):1179-89. doi: 10.3111/13696998.2013.832257. Epub 2013 Sep 5.
Understanding the value patients place on avoiding various aspects of chemotherapy induced nausea and vomiting (CINV) can help medical professionals assess whether current and emerging treatments are acceptable based on their costs and expected effects. Little is known, however, about the value patients place on avoiding various aspects of CINV. The current study helps fill this gap in the literature.
301 patients completed a discrete-choice conjoint survey. Patients viewed 25 conjoint tasks, each containing two descriptions of CINV, and indicated which they preferred. The descriptions combined levels from eight CINV attributes (likelihood of nausea, duration of nausea, severity of nausea, likelihood of vomiting, duration of vomiting, severity of vomiting, need to seek treatment for dehydration, and out-of-pocket treatment costs).
Cost contributed more to patient choices than any other single attribute. The combined effect of the likelihood, duration, and severity attributes for nausea, however, was a stronger driver of patient choices than cost, as was the combined effect of the likelihood, duration, and severity attributes for vomiting. The nausea attributes also were a stronger driver of patient choices than the vomiting attributes. Patients were willing to pay to avoid increases in all attributes, except likelihood of vomiting, where the result was not statistically different from zero. Willingness-to-pay varied by income, disease stage, Eastern Cooperative Oncology Group performance status, chemotherapy status, and whether patients worked while on chemotherapy.
Although the study used a convenience sample, data were collected from several geographically dispersed U.S. oncology clinics.
Several antiemetics are now available at different price points. This study assesses the value patients place on their benefits and may be used to inform decisions about the management of CINV.
了解患者对避免化疗引起的恶心和呕吐（CINV）各方面的重视程度，有助于医疗专业人员根据成本和预期效果评估当前和新兴疗法是否可以接受。然而，对于患者对避免 CINV 各方面的重视程度，我们知之甚少。本研究有助于填补这一文献空白。
301 名患者完成了离散选择联合调查。患者查看了 25 个联合任务，每个任务都包含两种 CINV 描述，并表明他们更喜欢哪一种。这些描述结合了 CINV 八个属性的水平（恶心的可能性、恶心的持续时间、恶心的严重程度、呕吐的可能性、呕吐的持续时间、呕吐的严重程度、需要治疗脱水的可能性和自付治疗费用）。
成本比任何其他单一属性对患者选择的影响都更大。然而，恶心的可能性、持续时间和严重程度属性的综合影响比成本更能驱动患者选择，呕吐的可能性、持续时间和严重程度属性的综合影响也是如此。恶心属性也比呕吐属性更能驱动患者选择。患者愿意支付费用来避免所有属性的增加，除了呕吐的可能性，其结果与零没有统计学差异。支付意愿因收入、疾病阶段、东部合作肿瘤学组表现状态、化疗状况以及患者在化疗期间是否工作而异。
尽管该研究使用了便利样本，但数据是从美国几个地理位置分散的肿瘤学诊所收集的。
现在有几种止吐药价格不同。本研究评估了患者对其益处的重视程度，可能有助于为 CINV 的管理决策提供信息。
