title: Cancer patients acceptance, understanding, and willingness-to-pay for pharmacogenomic testing.
abstract: BACKGROUND
  Pharmacogenomics is gaining increasing importance in the therapeutics of cancer; yet, there is little knowledge of cancer patients' attitudes toward the use of pharmacogenomic testing in clinical practice. We carried out this study to explore cancer patients' acceptance, understanding, and willingness-to-pay for pharmacogenomic testing.
  
  
  METHODS
  A broad cross-section of gastrointestinal, lung, breast, and other cancer patients were interviewed in terms of their acceptance of pharmacogenomic testing using hypothetical time, efficacy, and toxicity trade-off and willingness-to-pay scenarios.
  
  
  RESULTS
  Among the 96% of 123 adjuvant patients accepting chemotherapy under optimal conditions, 99% wanted pharmacogenomic testing that could identify a subset of patients benefiting from chemotherapy, accepting median incurred costs of $2000 (range $0-25,000) and turnaround time for test results of 16 days (range 0-90 days). Among the 97% of 121 metastatic patients accepting chemotherapy, 97.4% wanted pharmacogenomic testing that could detect the risk of severe toxicity, accepting median incurred costs of $1000 (range $0-10,000) and turnaround time for results of 14 days (range 1-90 days). The majority of patients wanted to be involved in decision-making on pharmacogenomic testing; however, one in five patients lacked a basic understanding of pharmacogenomic testing.
  
  
  CONCLUSIONS
  Among cancer patients willing to undergo chemotherapy, almost all wanted pharmacogenomic testing and were willing-to-pay for it, waiting several weeks for results. Although patients had a strong desire to be involved in decision-making on pharmacogenomic testing, a considerable proportion lacked the necessary knowledge to make informed choices.
authors.affiliation: Departments of aMedical Oncology bBiostatistics, Princess Margaret Cancer Centre, University of Toronto cDepartment of Medicine, University Health Network, Toronto, Ontario, Canada dProgram in Personalized Medicine and Targeted Therapeutics, Department of Health Policy and Public Health, University of the Sciences, Philadelphia, Pennsylvania, USA.
authors.forename: Sinead
authors.initials: S
authors.lastname: Cuffe
authors.forename: Henrique
authors.initials: H
authors.lastname: Hon
authors.forename: Xin
authors.initials: X
authors.lastname: Qiu
authors.forename: Kimberly
authors.initials: K
authors.lastname: Tobros
authors.forename: Chung-Kwun Amy
authors.initials: CK
authors.lastname: Wong
authors.forename: Bradley
authors.initials: B
authors.lastname: De Souza
authors.forename: Graham
authors.initials: G
authors.lastname: McFarlane
authors.forename: Sohaib
authors.initials: S
authors.lastname: Masroor
authors.forename: Abul K
authors.initials: AK
authors.lastname: Azad
authors.forename: Ekta
authors.initials: E
authors.lastname: Hasani
authors.forename: Natalie
authors.initials: N
authors.lastname: Rozanec
authors.forename: Natasha
authors.initials: N
authors.lastname: Leighl
authors.forename: Shabbir
authors.initials: S
authors.lastname: Alibhai
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Amalia M
authors.initials: AM
authors.lastname: Issa
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D005820:Genetic Testing / Q000191:economics* / Q000639:trends; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000191:economics / Q000235:genetics*; D057240:Patient Preference; D010597:Pharmacogenetics / Q000191:economics* / Q000639:trends; D057285:Precision Medicine / Q000191:economics* / Q000639:trends; D012306:Risk; D011795:Surveys and Questionnaires; D055815:Young Adult