Treatment preferences of advanced ovarian cancer patients for adding bevacizumab to first-line therapy

• Published in: Gynecologic oncology 2016-12, Vol.143 (3), p.622-627
• Main Authors: Lee, Jung-Yun, Kim, Kyunghoon, Lee, Yun Shin, Kim, Hyo Young, Nam, Eun Ji, Kim, Sunghoon, Kim, Sang Wun, Kim, Jae Weon, Kim, Young Tae
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - economics; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab; Bevacizumab - administration & dosage; Bevacizumab - economics; Chemotherapy, Adjuvant - economics; Chemotherapy, Adjuvant - methods; Choice Behavior; Cost-Benefit Analysis; Cytoreduction Surgical Procedures; Discrete choice experiment; Disease-Free Survival; Drug Costs; Female; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Neoplasm Staging; Neoplasms, Cystic, Mucinous, and Serous - drug therapy; Neoplasms, Cystic, Mucinous, and Serous - pathology; Neoplasms, Cystic, Mucinous, and Serous - psychology; Obstetrics and Gynecology; Ovarian cancer; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Ovarian Neoplasms - psychology; Patient Preference; Trade-off question; Treatment preference
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2016.10.021

Abstract Background The GOG-218 and ICON-7 studies recently showed that adding bevacizumab to first-line therapy for patients with advanced ovarian cancer increased progression-free survival. However, the high cost and long treatment duration prevents the incorporation of bevacizumab in practice. The aim of this study was to explore and quantify patients' preferences for adding bevacizumab to first-line therapy. Methods A discrete choice experiment (DCE) and trade-off question were designed and distributed to 102 ovarian cancer patients. Participants were asked to choose between two hypothetical first-line therapies that differed in terms of effectiveness, safety, and the financial burden. A trade-off technique varying the cost of bevacizumab was used to quantify a willingness-to-pay threshold for selecting bevacizumab. Results All attributes of the DCE had a statistically significant impact on respondents' preferences and the financial burden was the most important attribute. The results of the trade-off question showed that more than half of patients would prefer to add bevacizumab to standard chemotherapy when the cost of the drug was reduced to 17% (1/6) of the baseline cost. Conclusion Patients' preferences for bevacizumab in the adjuvant treatment of ovarian cancer depend primarily on drug costs. Our results suggest that the current cost of bevacizumab is sufficiently high that the majority of ovarian cancer patients are not willing to pay to accept a small increase in progression-free survival.