PCN272 Treatment of Advanced Renal Cell Carcinoma in Spain: Oncologists’ Preferences

Abstract

Several systemic therapy options are available for advanced renal cell carcinoma (aRCC) and physicians assess the appropriate regimen for each patient based on treatment characteristics. The aim of the study is to determine oncologists' preferences for the characteristics of aRCC treatment in Spain. Observational study based on a discrete choice experiment (DCE), developed in four phases: 1) setting up a scientific committee to lead the project; 2) literature review to identify treatment characteristics; 3) focus groups (5 patients, 8 oncologists) to prioritize characteristics; 4) survey development. Five treatment attributes, with three levels each, were included in the DCE: survival gain (6months, 1.5years, 3years), severe adverse effects (SAEs) (5%, 15%, 30%), health-related quality of life (HRQoL) (worse, maintained, improved), administration mode (oral 1-2/day, intravenous monthly, intravenous every 15 days) and monthly cost (€3000, €5000, €8000). Data were analyzed using a mixed logit model. Relative importance (RI) of attributes was calculated. Additionally, willingness to pay for the treatment (cost assumed by the health system) and maximum acceptable risk (MAR) of SAEs in exchange for clinical efficacy were estimated from the DCE. Sixty-seven oncologists participated in the study (52.2% men, mean age 41.9 years [standard deviation: 8.4]). All attributes/levels were significant (p<0.05), except for monthly intravenous administration and HRQoL maintenance. The highest RI was attributed to survival gain (54.7%), followed by HRQoL (18.0%), administration mode (11.1%), SAEs (10.8%), and treatment cost (5.5%). Higher cost would be accepted for extending survival by 1 month than for reducing SAEs risk by 1%. The MAR in exchange for extending survival by 1 month was 4.2%. From the oncologist’s perspective, survival gain is the primary goal of aRCC treatment. HRQoL, administration mode and SAEs are also important attributes to consider for decision-making, while treatment cost has low impact on treatment election.