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The following is a summary of “Preferences for speed of access versus certainty of the survival benefit of new cancer drugs: a discrete choice experiment,” published in the December 2024 issue of Oncology by Forrest et al.
The extent to which people with cancer are willing to accept uncertainty about the clinical benefit of new cancer drugs in exchange for faster access is unknown.
Researchers conducted a prospective study to examine people’s preferences for access vs. certainty regarding cancer drug benefits.
They surveyed a nationally representative sample of 998 adults aged 55 and older in the U.S. 870 participants with cancer experience via an online discrete choice experiment, which was included in the final analysis. Participants considered drug attributes such as functional status, life expectancy, certainty of survival benefit, surrogate endpoint effects, and delays in U.S. FDA approval.
The results showed that participants preferred high certainty of survival benefit (coefficient 2.61, 95% CI 2.23 to 2.99) and opposed a 1-year delay in FDA approval (coefficient –1.04, 95% CI –1.31 to –0.77). When certainty about the drug’s survival benefit was very low (no evidence linking a surrogate endpoint to OS), participants were willing to wait up to 21.68 months (95% CI 17.61 to 25.74) for strong evidence of survival benefit. The drug’s effect on a surrogate endpoint did not significantly influence participants’ choices (coefficient 0.02, 95% CI –0.21 to 0.25). Older participants (aged ≥55 years), non-White, lower-income individuals (earning <$40,000 per year), and those with lower life expectancy were most sensitive to wait time.
They concluded that people with cancer prioritize certainty about the survival benefit of new cancer drugs, with some willing to wait longer than current approval timelines for greater certainty.
Source: thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00596-5/fulltext
