title: Treatment preferences of advanced ovarian cancer patients for adding bevacizumab to first-line therapy.
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.
  
  
  CONCLUSIONS
  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.
authors: Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jung-Yun
authors: JY
authors: Lee
authors: Korea Information Society Development Institute, Chungcheongbuk-do, Republic of Korea.
authors: Kyunghoon
authors: K
authors: Kim
authors: KAIST College of Business, Korea Advanced Institute of Science and Technology, Seoul, Republic of Korea.
authors: Yun Shin
authors: YS
authors: Lee
authors: KAIST College of Business, Korea Advanced Institute of Science and Technology, Seoul, Republic of Korea.
authors: Hyo Young
authors: HY
authors: Kim
authors: Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Eun Ji
authors: EJ
authors: Nam
authors: Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: shkim70@yuhs.ac.
authors: Sunghoon
authors: S
authors: Kim
authors: Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Sang Wun
authors: SW
authors: Kim
authors: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Jae Weon
authors: JW
authors: Kim
authors: Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: ytkchoi@yuhs.ac.
authors: Young Tae
authors: YT
authors: Kim
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000191:economics; D017024:Chemotherapy, Adjuvant / Q000191:economics / Q000379:methods*; D002755:Choice Behavior; D003362:Cost-Benefit Analysis; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D016527:Drug Costs; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D057240:Patient Preference
chemical_list: D000068258:Bevacizumab
keywords: Bevacizumab; Discrete choice experiment; Ovarian cancer; Trade-off question; Treatment preference