OBJECTIVES: The different alternatives for non-small-cell lung cancer (NSCLC) treatment can increase survival, but cause important adverse events. Therefore, patients’ opinion can play a critical role in decision-making. Among stated preference methods, discrete choice experiment (DCE) is the most applied in health care. This research aims to evaluate the trade-off between the risks (adverse events) and benefits (survival) of systemic treatments, from the perspective of Brazilian patients with locally advanced, metastatic or recurrent NSCLC.

METHODS: We performed a DCE through the steps of attributes selection from literature review and focus groups; scenarios construction; pilot study and interviews. Patients chose between 2 hypothetical treatments described by the attributes tiredness, hairloss, skin rash, hospitalization, administration mode and survival. The statistical data analysis used a mixed logit model to predict the relative importance of the attributes.

RESULTS: Most of the 65 patients interviewed were men (53.8%), mean age of 65 (95% confidence interval [CI]: 63-67) years and lung cancer stage IV (67.7%). Except for hospitalization and administration mode, the attributes coefficients were statistically significant (p < 0.005) for patients’ preferences. Patients would require a minimum survival gain of 11.72 (CI: 10.28-4.22) months and 19.72 (CI: 17.31‐7.09) months to accept a treatment that causes severe tiredness and severe skin rash, respectively. We estimated the market share for the alternative treatments from the utility calculation. Paclitaxel plus carboplatin had an estimated market share of 31%, followed by gefitinib (27%), erlotinib (24%) and docetaxel (18%).

CONCLUSIONS: This study showed that new treatments with a safest profile have a high potential to achieve patients’ preference, regardless of administration mode. In general, less than one year of survival gain would not compensate the possibility of living with severe forms of skin rash or tiredness.