Preferences for public health insurance coverage of new anticancer drugs: a discrete choice experiment among non-small cell lung cancer patients in China.

Background: Ensuring equal access to affordable, high-quality, and satisfied healthcare for cancer patients is a challenge worldwide. Our study aimed to investigate preferences for public health insurance coverage of new anticancer drugs among non-small cell lung cancer (NSCLC) patients in China.

Methods: We identified six attributes of new anticancer drugs and adopted a Bayesian-efficient design to generate choice scenarios for a discrete choice experiment (DCE). The one-on-one, face-to-face DCE was conducted in four cities in Jiangsu Province. The mixed logit regression model was used to estimate patient-reported preferences for each attribute. The interaction model was used to investigate preference heterogeneity.

Results: Data from 486 patients were available for analysis. The most valuable attribute was the out-of-pocket cost if reimbursed (RI = 32.25%), followed by extension of overall survival (RI = 15.99%), and low incidence of serious side effects (RI = 14.45%). Patients had the highest willingness to pay for the comparative 9-month' extension of overall survival. Patients with advanced NSCLC were more likely to expect new anticancer drugs could improve HRQoL (p < 0.01) and require fewer out-of-pocket costs (p < 0.01). Older patients and patients with low income cared more about the out-of-pocket costs (p < 0.001).

Conclusion: Health insurance policymakers need to consider the affordability, comparative survival benefits, comparative safety, and comparative patient-reported outcomes of new anticancer drugs. The findings also highlight the need to ensure affordability for older patients, low-income patients, and patients with advanced cancer.