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Patient Benefit-Risk Preferences for Targeted Agents in the Treatment of Renal Cell Carcinoma

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  • Ateesha Mohamed
  • A. Hauber
  • Maureen Neary

Abstract

Background: Angiogenesis inhibitor agents have been shown to be effective in increasing progression-free survival (PFS) in patients with renal cell carcinoma (RCC); however, these treatments have different toxicity profiles. Objective: Our objective was to quantify patients’ benefit-risk preferences for RCC treatments and relative importance of attributes in a common metric. Methods: US residents aged ≥18 years with RCC completed a web-enabled, choice-format conjoint survey that presented a series of 12 trade-off questions, each including a pair of hypothetical RCC treatment profiles. Each profile was defined by efficacy (PFS, when overall survival held constant), tolerability effects (fatigue/tiredness, diarrhoea, hand-foot syndrome [HFS], mouth sores) and serious adverse events (liver failure, blood clot). Trade-off questions were based on a predetermined experimental design with known statistical properties. Random-parameters logit was used to analyse the data. Results: A total of 138 patients completed the survey. PFS was the most important attribute for patients over the range of levels included in the survey, while remaining attributes were ranked in decreasing order of importance: fatigue/tiredness, diarrhoea, liver failure, HFS, blood clot and mouth sores. In order to increase PFS by 11 months, patients would be willing to accept a maximum level of absolute blood clot risk of 3.1%(95%CI 1.5, 5.3) or liver failure risk of 2.0% (95% CI 1.0, 3.3). Conclusion: A 22-month change in PFS was shown to be the most important improvement for patients. Severe fatigue/tiredness and diarrhoea were rated as the most troublesome tolerability effects of RCC treatment. Patients were likely willing to accept significant treatment-related risks of 2–3% for liver failure and blood clot to increase PFS by 11 months. Copyright Springer International Publishing AG 2011

Suggested Citation

  • Ateesha Mohamed & A. Hauber & Maureen Neary, 2011. "Patient Benefit-Risk Preferences for Targeted Agents in the Treatment of Renal Cell Carcinoma," PharmacoEconomics, Springer, vol. 29(11), pages 977-988, November.
    • Handle: RePEc:spr:pharme:v:29:y:2011:i:11:p:977-988
    DOI: 10.2165/11593370-000000000-00000
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    References listed on IDEAS

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    1. John Bridges & Elizabeth Kinter & Lillian Kidane & Rebekah Heinzen & Colleen McCormick, 2008. "Things are Looking up Since We Started Listening to Patients," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 1(4), pages 273-282, October.
    2. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555, September.
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    4. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, October.
    5. Stirling Bryan & Martin Buxton & Robert Sheldon & Alison Grant, 1998. "Magnetic resonance imaging for the investigation of knee injuries: an investigation of preferences," Health Economics, John Wiley & Sons, Ltd., vol. 7(7), pages 595-603, November.
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    1. Mark Harrison & Dan Rigby & Caroline Vass & Terry Flynn & Jordan Louviere & Katherine Payne, 2014. "Risk as an Attribute in Discrete Choice Experiments: A Systematic Review of the Literature," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(2), pages 151-170, June.

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