QUALITATIVE INSIGHTS ON ONE-TIME TREATMENT PREFERENCES INFORMING A DCE IN KOREA
Author(s)
Sojeong Bae, PharmD1, Gyeongseon Shin, PharmD, PhD2, Seungjin Bae, ScD1.
1College of Pharmacy, Ewha Womans University, Seoul, Korea, Republic of, 2College of Pharmacy, Wonkwang University, Iksan, Korea, Republic of.
1College of Pharmacy, Ewha Womans University, Seoul, Korea, Republic of, 2College of Pharmacy, Wonkwang University, Iksan, Korea, Republic of.
OBJECTIVES: High-cost one-time treatments, such as CAR-T and other cell and gene therapies, pose complex treatment decisions because of uncertain long-term outcomes and substantial out-of-pocket costs. This study explored cancer patients’ preferences and refined attributes for a large-scale stated-preference survey.
METHODS: Six in-depth cognitive interviews were conducted with Korean cancer patients with hematologic and solid tumors. Participants reviewed educational materials, completed best-worst scaling (BWS) and discrete choice experiment (DCE) tasks, and discussed their understanding and rationale for treatment decisions. Responses were assessed under three hypothetical scenarios: as oneself, as a parent of a 5-year-old, and as a 70-year-old patient.
RESULTS: Four key patterns emerged. First, treatment waiting time was evaluated relative to life expectancy; patients with shorter expected survival preferred immediate treatment despite uncertainty. Second, most participants expressed willingness-to-pay (WTP) values for one-time treatments, typically around KRW 100-200 million in out-of-pocket costs. Third, preferences varied considerably by context. When responding as parents of a young child, participants showed higher WTP values and greater concern about side effects. In contrast, decisions for elderly patients reflected lower WTP values and greater sensitivity to treatment delays. Fourth, disease severity and availability of alternative therapies strongly influenced choices. Patients with remaining treatment options were more willing to continue existing therapies while waiting for additional long-term evidence, whereas those without alternatives preferred immediate access despite uncertain outcomes. Greater disease severity also heightened the perceived importance of side effects.
CONCLUSIONS: Preferences for one-time treatments depend not only on economic factors but also on clinical and social contexts. Differences across self, parental, and elderly perspectives highlight the importance of multiple viewpoints in preference elicitation. Ultimately, these results provide practical insights for future preference studies and value-based reimbursement policies for high-cost therapies.
METHODS: Six in-depth cognitive interviews were conducted with Korean cancer patients with hematologic and solid tumors. Participants reviewed educational materials, completed best-worst scaling (BWS) and discrete choice experiment (DCE) tasks, and discussed their understanding and rationale for treatment decisions. Responses were assessed under three hypothetical scenarios: as oneself, as a parent of a 5-year-old, and as a 70-year-old patient.
RESULTS: Four key patterns emerged. First, treatment waiting time was evaluated relative to life expectancy; patients with shorter expected survival preferred immediate treatment despite uncertainty. Second, most participants expressed willingness-to-pay (WTP) values for one-time treatments, typically around KRW 100-200 million in out-of-pocket costs. Third, preferences varied considerably by context. When responding as parents of a young child, participants showed higher WTP values and greater concern about side effects. In contrast, decisions for elderly patients reflected lower WTP values and greater sensitivity to treatment delays. Fourth, disease severity and availability of alternative therapies strongly influenced choices. Patients with remaining treatment options were more willing to continue existing therapies while waiting for additional long-term evidence, whereas those without alternatives preferred immediate access despite uncertain outcomes. Greater disease severity also heightened the perceived importance of side effects.
CONCLUSIONS: Preferences for one-time treatments depend not only on economic factors but also on clinical and social contexts. Differences across self, parental, and elderly perspectives highlight the importance of multiple viewpoints in preference elicitation. Ultimately, these results provide practical insights for future preference studies and value-based reimbursement policies for high-cost therapies.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
PCR31
Topic
Patient-Centered Research
Disease
SDC: Oncology