Willingness to pay to prevent chemotherapy induced nausea and vomiting among patients with breast, lung, or colorectal cancer

J Med Econ. 2013 Oct;16(10):1179-89. doi: 10.3111/13696998.2013.832257. Epub 2013 Sep 5.


Objective: Understanding the value patients place on avoiding various aspects of chemotherapy induced nausea and vomiting (CINV) can help medical professionals assess whether current and emerging treatments are acceptable based on their costs and expected effects. Little is known, however, about the value patients place on avoiding various aspects of CINV. The current study helps fill this gap in the literature.

Methods: 301 patients completed a discrete-choice conjoint survey. Patients viewed 25 conjoint tasks, each containing two descriptions of CINV, and indicated which they preferred. The descriptions combined levels from eight CINV attributes (likelihood of nausea, duration of nausea, severity of nausea, likelihood of vomiting, duration of vomiting, severity of vomiting, need to seek treatment for dehydration, and out-of-pocket treatment costs).

Results: Cost contributed more to patient choices than any other single attribute. The combined effect of the likelihood, duration, and severity attributes for nausea, however, was a stronger driver of patient choices than cost, as was the combined effect of the likelihood, duration, and severity attributes for vomiting. The nausea attributes also were a stronger driver of patient choices than the vomiting attributes. Patients were willing to pay to avoid increases in all attributes, except likelihood of vomiting, where the result was not statistically different from zero. Willingness-to-pay varied by income, disease stage, Eastern Cooperative Oncology Group performance status, chemotherapy status, and whether patients worked while on chemotherapy.

Limitations: Although the study used a convenience sample, data were collected from several geographically dispersed U.S. oncology clinics.

Conclusions: Several antiemetics are now available at different price points. This study assesses the value patients place on their benefits and may be used to inform decisions about the management of CINV.

MeSH terms

  • Antiemetics / administration & dosage
  • Antiemetics / economics*
  • Antiemetics / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / economics
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / economics
  • Cancer Care Facilities / economics
  • Cancer Care Facilities / statistics & numerical data
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / economics
  • Decision Making
  • Female
  • Financing, Personal
  • Health Expenditures*
  • Humans
  • Likelihood Functions
  • Lung Neoplasms / complications
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / economics
  • Male
  • Middle Aged
  • Nausea / chemically induced
  • Nausea / economics
  • Nausea / prevention & control*
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Neoplasms / economics
  • Patient Acceptance of Health Care*
  • Severity of Illness Index
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • United States
  • Vomiting / chemically induced
  • Vomiting / economics
  • Vomiting / prevention & control*


  • Antiemetics
  • Antineoplastic Agents