From Research to Policy: Incorporating Patient Preferences for Colorectal Cancer Treatments Into Health Technology Assessment
Author(s)
Carina Oedingen, PhD1, Karen V. MacDonald, MPH1, Barry D. Stein, CEO2, Deborah A. Marshall, PhD1;
1University of Calgary, Cumming School of Medicine, Calgary, AB, Canada, 2Colorectal Cancer Canada, Westmount, QC, Canada
1University of Calgary, Cumming School of Medicine, Calgary, AB, Canada, 2Colorectal Cancer Canada, Westmount, QC, Canada
OBJECTIVES: There is growing interest to integrate patient preferences into health technology assessment (HTA) for drug reimbursement recommendations. However, approaches remain unexplored. The Patient Values Project aims to explore how to incorporate quantitative patient preferences for colorectal cancer treatments in a systematic manner into Canadian HTA.
METHODS: We developed a preference survey that included two discrete choice experiments (DCEs; DCE1: quality-of-life versus survival; DCE2: value of treatment attributes) and one best-worst scaling (BWS; treatment side effects) to estimate preferences for colorectal cancer treatments. The survey was administered across Canada to metastatic colorectal cancer patients (n=104), caregivers (n=57) and adults from the general population (n=441). Data were analyzed using mixed logit (DCEs) and count-based analysis (BWS). Results were then used as case examples to explore how to effectively incorporate preferences into HTA.
RESULTS: We observed preference heterogeneity across samples. DCE1 showed patients prioritize survival over quality-of-life more than the general population. DCE2 revealed caregivers prioritize avoiding side effects more than patients or the general population. BWS indicated similar rankings of most and least tolerable side effects for all samples. The following aspects were identified as essential for integrating patient preferences into HTA: (1) whose preferences should be included (e.g., preference heterogeneity), (2) when and how often should these data be collected (e.g., different treatment points), (3) how to include these data explicitly and operationally into HTA, (4) which attributes should be included for HTA (e.g., align with clinical trial endpoints or the most important), and (5) how can the results be generalizable across other cancer types.
CONCLUSIONS: The Patient Values Project is the first step in developing a systematic and structured approach for incorporating patient preferences into HTA alongside clinical and economic evidence. The novelty and relevance of this research can ultimately change how policymakers use patient preferences in patient-oriented decision-making.
METHODS: We developed a preference survey that included two discrete choice experiments (DCEs; DCE1: quality-of-life versus survival; DCE2: value of treatment attributes) and one best-worst scaling (BWS; treatment side effects) to estimate preferences for colorectal cancer treatments. The survey was administered across Canada to metastatic colorectal cancer patients (n=104), caregivers (n=57) and adults from the general population (n=441). Data were analyzed using mixed logit (DCEs) and count-based analysis (BWS). Results were then used as case examples to explore how to effectively incorporate preferences into HTA.
RESULTS: We observed preference heterogeneity across samples. DCE1 showed patients prioritize survival over quality-of-life more than the general population. DCE2 revealed caregivers prioritize avoiding side effects more than patients or the general population. BWS indicated similar rankings of most and least tolerable side effects for all samples. The following aspects were identified as essential for integrating patient preferences into HTA: (1) whose preferences should be included (e.g., preference heterogeneity), (2) when and how often should these data be collected (e.g., different treatment points), (3) how to include these data explicitly and operationally into HTA, (4) which attributes should be included for HTA (e.g., align with clinical trial endpoints or the most important), and (5) how can the results be generalizable across other cancer types.
CONCLUSIONS: The Patient Values Project is the first step in developing a systematic and structured approach for incorporating patient preferences into HTA alongside clinical and economic evidence. The novelty and relevance of this research can ultimately change how policymakers use patient preferences in patient-oriented decision-making.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
P6
Topic
Patient-Centered Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology