OBJECTIVES : Previous DCE in breast cancer demonstrated that functional wellbeing is deemed an important attribute related to breast cancer treatment, followed by pain and progression-free survival. We investigated to what extent the presence of other attributes, such as Overall survival (OS) affects their preferences.

METHODS : A DCE was conducted in France, Germany, Ireland, Poland, Spain, UK. Breast cancer (BC) patients. Pilot was conducted with large sample of general population (GenPop) women. Respondents were recruited via online panel. 16 choice sets, including Opting-out of treatment, were constructed with: Overall survival (OS), Hyperglycaemia, Rash, Pain, Functional well-being (FWB) and Out-of-pocket payment (OPP) as attributes. EQ-5D data were collected. Choices were analysed with conditional logistic model. Marginal rates of substitution (MRS) of out-of-pocket payment and other attributes were estimated. Joint models tested differences in preferences between two samples.

RESULTS : 516 patients (247 with advanced or metastatic BC and 314 with early-stage BC) responded. 66% and 12% of the total sample were in mild and extreme pain respectively. In addition, 125 GenPop (39% and 3% of which were in mild and extreme pain respectively) completed the survey. Moving from mild pain to no pain was valued higher than other attributes by patients, with MRS of €24,728 for one year in mild pain. This was followed by no impairment in FW (€24,703) and OS (€554 for one additional month of OS). GenPop most preferred attribute was no pain (MRS of OOP €17,232). Joint model demonstrated that there was no difference in preferences between the two samples for the OS.

CONCLUSIONS : Pain and functional wellbeing are decision drivers for patients. When faced with states of extreme pain or extreme impairment in functional wellbeing, patients would trade off survival for better quality of life.