OBJECTIVES : Patients′ involvement is becoming increasingly important by regulatory and Health Technology Assessment Organisations around Europe. The survey objectives′ were to understand breast cancer patients′ perspective when choosing their treatment, highlight treatment characteristics valued as most important by patients and gain information on patients′ trade-offs between available treatments.

METHODS : A DCE survey of breast cancer patients was conducted in Spain, Poland, France and Ireland. The survey design included: literature review, qualitative research, cognitive debriefing, data collection and analysis. A panel of experts from participating countries (physicians, patient group representatives, ex-payers) selected the survey treatment attributes: Progression free survival (PFS), Febrile neutropenia (FN), Pain, Functional well-being (FWB) and Out-of-pocket payment (OPP). Patients selected (or opted-out) between two unlabeled hypothetical treatments containing the previously mentioned five attributes. Panels of breast cancer patients were recruited as respondents and the questionnaire was deployed through a website platform. A D-efficient experimental design with 16 choice-sets was constructed and a conditional logistic model was used to estimate patients’ preferences. Marginal rates of substitution (MRS) was used to estimate out-of-pocket payments.

RESULTS : 371 breast cancer patients completed the survey. FWB and pain were the most important attributes chosen by patients from all countries. More specifically, Spanish, Polish and Irish patients were willing to offer €34,753, €45,712 and €32,222 respectively as out-of-pocket payments for moving from severe to no impairment in FWB. Spanish patients would pay €813 annually for one additional PFS month while Irish patients would pay €1,219.50 and Polish patients €2.575 respectively. French patients’ strongest preference was no pain and they were willing to pay €15,017 for moving from severe to no pain level.

CONCLUSIONS : Breast cancer treatments that improve FWB, pain and prolong PFS can be considered preferred treatments from patients’ perspective. Patients’ preferences should be incorporated in regulatory, HTA and industry decision-making processes.