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A Multinational Study to Measure the Value that Patients with Cancer Place on Improved Emesis Control Following Cisplatin Chemotherapy

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Abstract

Background: The neurokinin-1 (NK1) receptor antagonists are a new class of agents designed to reduce the risk of emesis following chemotherapy, particularly with cisplatin. Early data from double-blind randomised trials suggest that an orally administered NK1 antagonist can reduce the absolute risk of acute and delayed emesis following cisplatin by 20 and 30%, respectively.

Objective: To measure the value that patients with cancer place on improved emesis control and quality of life.

Design: Willingness-to-pay analysis.

Setting: Five study sites in Canada, Italy, Spain and Greece. Patients and participants: 245 patients with cancer either receiving chemotherapy with cisplatin or who had received cisplatin-based chemotherapy within the previous 6 months.

Methods: After background information had been presented, patientswere asked to define the maximum that they would pay per day for a drug that reduced their risk of acute and delayed (days 2 to 5) emesis by 20 and 30%, respectively. Costs were converted to US dollars ($US) using year 2000 exchange rates.

Results: For a 20% improvement in acute emesis, Canadian, Italian and Spanish patients with cancer were willing to pay $US46, $US34 and $US63 per day, respectively, compared with $US8 for patients from Greece (p < 0.001). For a 30% improvement in delayed emesis, Canadian, Italian and Spanish patientswith cancer were also willing to pay more than their Greek counterparts ($US41, $US31, $US50 and $US9 daily for 4 days, respectively; p < 0.001). These significant differences in patient value between countries remained, even after adjusting for socioeconomic variables and previous history of emesis.

Conclusions: There are substantial cultural differences in how patients with cancer value benefit and improved quality of life. Since the majority of the world’s population resides outside North America and Western Europe, there may be a need to re-evaluate perceived levels of patient benefit and measures of quality of life.

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Acknowledgements

This study was supported in part through a research grant from Glaxo Wellcome, United Kingdom. The authors are members of the Pharmacoeconomics Study Group in Cancer Supportive Care.

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Authors and Affiliations

  1. Department of Pharmaceutical Services, Department of Molecular Biology, University Health Network/Princess Margaret Hospital, 610 University Avenue, Room 9-113, Toronto, Ontario, M5G 2M9, Canada

    George Dranitsaris & Pauline Leung

  2. Molecular Biology, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Ontario, Canada

    George Dranitsaris

  3. Department of Medical Oncology, Azienda Ospedaliera, Treviglio, Italy

    Renoto Ciotti

  4. Servicio de Farmacia, Clinica Universitaria de Navarra, Pamplona, Spain

    Ana Ortega

  5. Center for Health Services Management and Evaluation, University of Athens, Athens, Greece

    Maria Spinthouri & Lycurgus Liaropoulos

  6. Azienda Ospedaliera, Ospedali Riuntiti di Bergamo, Bergamo, Italy

    Roberto Labianca & Antonello Quadri

Authors
  1. George Dranitsaris
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  2. Pauline Leung
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  3. Renoto Ciotti
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  4. Ana Ortega
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  5. Maria Spinthouri
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  6. Lycurgus Liaropoulos
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  7. Roberto Labianca
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  8. Antonello Quadri
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Correspondence to George Dranitsaris.

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Dranitsaris, G., Leung, P., Ciotti, R. et al. A Multinational Study to Measure the Value that Patients with Cancer Place on Improved Emesis Control Following Cisplatin Chemotherapy. Pharmacoeconomics 19, 955–967 (2001). https://doi.org/10.2165/00019053-200119090-00007

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  • DOI: https://doi.org/10.2165/00019053-200119090-00007

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