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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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Author Info

  • George Dranitsaris

    (Department of Pharmaceutical Services, University Health Network/Princess Margaret Hospital, Toronto, Ontario, Canada)

  • Pauline Leung

    (Department of Pharmaceutical Services, University Health Network/Princess Margaret Hospital, Toronto, Ontario, Canada)

  • Renoto Ciotti

    (Department of Medical Oncology, Azienda Ospedaliera, Treviglio, Italy)

  • Ana Ortega

    (Servicio de Farmacia, Clinica Universitaria de Navarra, Pamplona, Spain)

  • Maria Spinthouri

    (Center for Health Services Management and Evaluation, University of Athens, Athens, Greece)

  • Lycurgus Liaropoulos

    (Center for Health Services Management and Evaluation, University of Athens, Athens, Greece)

  • Roberto Labianca

    (Azienda Ospedaliera, Ospedali Riuntiti di Bergamo, Bergamo, Italy)

  • Antonello Quadri

    (Azienda Ospedaliera, Ospedali Riuntiti di Bergamo, Bergamo, Italy)

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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, patients were 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 $US8 for patients from Greece (p < 0.001). For a 30% improvement in delayed emesis, Canadian, Italian and Spanish patients with cancer were also willing to pay more than their Greek counterparts ($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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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 19 (2001)
    Issue (Month): 9 ()
    Pages: 955-967
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:19:y:2001:i:9:p:955-967

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    Web page: http://pharmacoeconomics.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Antiemetics; Nausea; Neurokinin 1 antagonists; Pharmacoeconomics; Quality of life; Vomiting;

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