title: Willingness to accept chemotherapy and attitudes towards costs of cancer treatment; A multisite survey study in the Netherlands.
abstract: BACKGROUND
  In the past years, interest in patient treatment preferences is growing. Our objectives were: (1) to assess and compare the minimal required benefit for patients with cancer, patients without cancer and healthcare professionals to make chemotherapy acceptable and (2) to obtain insight into attitudes towards societal costs of cancer treatment.
  
  
  METHODS
  We performed a prospective survey consisting of hypothetical scenarios among patients with cancer, patients without cancer and healthcare professionals. Participants were asked to indicate the minimal desired benefit in terms of chance of cure, life prolongation and symptom relief which would make intensive and mild chemotherapy regimens acceptable. In two other scenarios, attitudes towards monthly costs for chemotherapy treatment were examined.
  
  
  RESULTS
  The minimal benefit required to make chemotherapy acceptable did not differ between cancer and non-cancer patients, with respect to chance of cure (mean 57%), life prolongation (median 24 months) and symptom relief (mean 50%); healthcare providers were likely to accept the same chemotherapy regimen at lower thresholds (p < 0.01). Education level was an important explanatory variable and the differences between patients and healthcare professionals disappeared when corrected for education level. Opinions about the maximum acceptable costs for chemotherapy displayed a large spread between the groups.
  
  
  CONCLUSIONS
  Minimal benefits to accept chemotherapy were not different between cancer and non-cancer patients, but are beyond what can generally can be achieved. Healthcare professionals were willing to accept chemotherapy for less benefit. This difference may be attributed to a difference in education level between the groups. Healthcare professionals rated the maximum acceptable societal cost for chemotherapy lower than patients.
authors: Department of Medical Oncology, Medisch Spectrum Twente, Enschede, the Netherlands.
authors: E F M M
authors: EF
authors: van Dijk
authors: M
authors: M
authors: Coşkuntürk
authors: A T
authors: AT
authors: Zuur
authors: J
authors: J
authors: van der Palen
authors: W T A
authors: WT
authors: van der Graaf
authors: J N H
authors: JN
authors: Timmer-Bonte
authors: A N M
authors: AN
authors: Wymenga
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D001290:Attitude; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003657:Decision Making; D016527:Drug Costs; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000188:drug therapy*; D009426:Netherlands; D009726:Nurses; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D010820:Physicians; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents