Preliminary analysis of preferences and willingness to pay for central venous access in patients with breast cancer_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Shimeng ^1,2 , XIA Zhiyuan ^1,2 , FU Peifen ³ , ZHAO Pei ⁴ , LI Yinfeng ⁵ , CHEN Na ⁶ , WEI Yanan ⁴ , DU Chengyong ³ , MU Wenxuan ⁶ ,  CHEN Yingyao ^1,2

1. School of Public Health, Fudan University, Shanghai 200032, P. R. China;
2. NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai 200032, P. R. China;
3. Department of Breast Surgery, the First Affiliated Hospital, Zhejiang University, Hangzhou 310000, P. R. China;
4. Department of Breast Surgery, Henan Provincial People’s Hospital, Zhengzhou 450003, P. R. China;
5. Department of Nursing, Sichuan Cancer Hospital, Chengdu 610042, P. R. China;
6. Chengdu Medical College, Chengdu 610500, P. R. China;

Corresponding?author：

CHEN Yingyao, Email: yychen@shmu.edu.cn

Keywords：

Breast cancer; Patient preferences; Willingness to pay; Central venous access; Discrete choice experiment

DOI：

10.7507/1672-2531.202201024

Video：

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Objective This study aimed to quantitatively investigate the preferences and willingness of patients with breast cancer to pay for central venous access and to provide implications for the clinical selection of appropriate chemotherapy pathways. Methods A discrete-choice experiment survey was conducted to elicit the preferences for central venous access in three hospitals in east, middle and west China. The conditional logit model was used to analyse the relative importance of six central venous access-related attributes: risk of thrombosis, risk of infections, restriction of daily activities, maintenance interval, catheter incision size and out-of-pocket costs. Results The valid data for a total of 103 patients was collected from three hospitals. All six attributes significantly influenced patients’ preferences for central venous access. The risk of thrombosis (RIS=26.0%) and risk of infections (RIS=24.3%) were the top two attributes influencing patients’ preferences for central venous access. To reduce the risk of thrombosis and infection from 12% and 8% to 1%, patients were willing to pay 14 861.2 yuan and 13 907.2 yuan, respectively. The catheter incision size was of least concern (RIS=4.6%); the patients were only willing to pay 2 653.6 yuan for smaller catheter incisions. Conclusion Thrombosis and infection are the primary factors that affect the choice of central venous access for patients with breast cancer. Patients have a sensitive trade-off between safety and out-of-pocket costs; with the change in thrombosis and infection risk, patients’ willingness to pay changes accordingly.

Citation： LIU Shimeng, XIA Zhiyuan, FU Peifen, ZHAO Pei, LI Yinfeng, CHEN Na, WEI Yanan, DU Chengyong, MU Wenxuan, CHEN Yingyao. Preliminary analysis of preferences and willingness to pay for central venous access in patients with breast cancer. Chinese Journal of Evidence-Based Medicine, 2022, 22(4): 380-386. doi: 10.7507/1672-2531.202201024 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	李宜臻, 鄭怡, 鄧玉皎, 等. 1990~2019年中國女性乳腺癌疾病負擔及危險因素研究. 中國循證醫學雜志, 2021, 21(8): 876-881.
3.	中心靜脈血管通路裝置安全管理專家組. 中心靜脈血管通路裝置安全管理專家共識(2019版). 中華外科雜志, 2020, 58(4): 261-272.
4.	王凱蓉, 周英鳳. PICC與CVC, VPA經濟學評價研究的系統評價. 護理學雜志, 2019, 34(8): 54-58.
5.	徐鳳銀, 李惠芬, 李松琴, 等. 三種不同類型中心靜脈導管感染臨床特點分析. 齊魯護理雜志, 2019, 25(13): 31-34.
6.	徐文潔, 聞曲, 成芳, 等. 植入式靜脈輸液港與PICC臨床應用現狀比較. 中國護理管理, 2013, 13(12): 102-103.
7.	Clark MD, Determann D, Petrou S, et al. Discrete choice experiments in health economics: a review of the literature. Pharmacoeconomics, 2014, 32(9): 883-902.
8.	de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: a review of the literature. Health Econ, 2012, 21(2): 145-172.
9.	Soekhai V, de Bekker-Grob EW, Ellis AR, et al. Discrete choice experiments in health economics: past, present and future. Pharmacoeconomics, 2019, 37(2): 201-226.
10.	Thurstone LL. A law of comparative judgment. Psychol Rev, 1994, 101(2): 266-270.
11.	McFadden D. Conditional logit analysis of qualitative choice behavior. New York: Academic Press, 1974.
12.	胡婉俠, 徐文華, 徐建光, 等. 我國衛生領域離散選擇實驗應用研究的文獻計量分析. 南京醫科大學學報(社會科學版), 2020, 20(2): 157-161.
13.	劉世蒙, 夏志遠, 魏艷, 等. 離散選擇實驗在中心靜脈輸液裝置選擇偏好中的需求及應用分析. 中國藥物經濟學, 2021, 16(1): 5-9.
14.	陳莉, 羅鳳, 蔡明. 植入式靜脈輸液港并發癥及處理的研究進展. 中華乳腺病雜志(電子版), 2017, 11(2): 102-105.
15.	陳麗莉, 何惠燕, 毛曉群. 乳腺癌患者應用植入式中心靜脈輸液港的常見問題與對策. 中華護理雜志, 2011, 46(11): 1116-1117.
16.	畢鐵強, 周軍, 汪瑞, 等. 完全植入式靜脈輸液港與經外周靜脈穿刺中心靜脈置管在乳腺癌患者化療中的應用效果比較. 中華乳腺病雜志(電子版), 2014, 8(2): 103-108.
17.	Taxbro K, Hammarskj?ld F, Thelin B, et al. Clinical impact of peripherally inserted central catheters vs implanted port catheters in patients with cancer: an open-label, randomised, two-centre trial. Br J Anaesth, 2019, 122(6): 734-741.
18.	Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: ESMO clinical practice guidelines. Ann Oncol, 2015, 26 Suppl 5: 152-168.
19.	Schiffer CA, Mangu PB, Wade JC, et al. Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol, 2013, 31(10): 1357-1370.
20.	Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: a user's guide. Pharmacoeconomics, 2008, 26(8): 661-677.
21.	Pearmain D, Swanson J, Kroes E, et al. Stated preference techniques: a guide to practice (2nd ed). London: Steer Davies Gleave and Hague Consulting Group Press, 1991.
22.	Train KB. Discrete choice methods with simulation (2nd edition). Cambridge: Cambridge University Press, 2009.
23.	Lancsar E, Louviere J, Flynn T. Several methods to investigate relative attribute impact in stated preference experiments. Soc Sci Med, 2007, 64(8): 1738-1753.
24.	劉運江, 屈翔, 葛智成, 等. 乳腺癌植入式靜脈輸液港臨床應用專家共識及技術操作指南(2017版). 中國實用外科雜志, 2017, 37(12): 1377-1382.
25.	羅祎, 石磊, 江智霞, 等. 植入式靜脈輸液港與經外周靜脈穿刺中心靜脈置管在腫瘤化療中的應用效果評價. 中國實用護理雜志, 2015, 31(22): 1681-1685.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. 李宜臻, 鄭怡, 鄧玉皎, 等. 1990~2019年中國女性乳腺癌疾病負擔及危險因素研究. 中國循證醫學雜志, 2021, 21(8): 876-881.
3. 中心靜脈血管通路裝置安全管理專家組. 中心靜脈血管通路裝置安全管理專家共識(2019版). 中華外科雜志, 2020, 58(4): 261-272.
4. 王凱蓉, 周英鳳. PICC與CVC, VPA經濟學評價研究的系統評價. 護理學雜志, 2019, 34(8): 54-58.
5. 徐鳳銀, 李惠芬, 李松琴, 等. 三種不同類型中心靜脈導管感染臨床特點分析. 齊魯護理雜志, 2019, 25(13): 31-34.
6. 徐文潔, 聞曲, 成芳, 等. 植入式靜脈輸液港與PICC臨床應用現狀比較. 中國護理管理, 2013, 13(12): 102-103.
7. Clark MD, Determann D, Petrou S, et al. Discrete choice experiments in health economics: a review of the literature. Pharmacoeconomics, 2014, 32(9): 883-902.
8. de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: a review of the literature. Health Econ, 2012, 21(2): 145-172.
9. Soekhai V, de Bekker-Grob EW, Ellis AR, et al. Discrete choice experiments in health economics: past, present and future. Pharmacoeconomics, 2019, 37(2): 201-226.
10. Thurstone LL. A law of comparative judgment. Psychol Rev, 1994, 101(2): 266-270.
11. McFadden D. Conditional logit analysis of qualitative choice behavior. New York: Academic Press, 1974.
12. 胡婉俠, 徐文華, 徐建光, 等. 我國衛生領域離散選擇實驗應用研究的文獻計量分析. 南京醫科大學學報(社會科學版), 2020, 20(2): 157-161.
13. 劉世蒙, 夏志遠, 魏艷, 等. 離散選擇實驗在中心靜脈輸液裝置選擇偏好中的需求及應用分析. 中國藥物經濟學, 2021, 16(1): 5-9.
14. 陳莉, 羅鳳, 蔡明. 植入式靜脈輸液港并發癥及處理的研究進展. 中華乳腺病雜志(電子版), 2017, 11(2): 102-105.
15. 陳麗莉, 何惠燕, 毛曉群. 乳腺癌患者應用植入式中心靜脈輸液港的常見問題與對策. 中華護理雜志, 2011, 46(11): 1116-1117.
16. 畢鐵強, 周軍, 汪瑞, 等. 完全植入式靜脈輸液港與經外周靜脈穿刺中心靜脈置管在乳腺癌患者化療中的應用效果比較. 中華乳腺病雜志(電子版), 2014, 8(2): 103-108.
17. Taxbro K, Hammarskj?ld F, Thelin B, et al. Clinical impact of peripherally inserted central catheters vs implanted port catheters in patients with cancer: an open-label, randomised, two-centre trial. Br J Anaesth, 2019, 122(6): 734-741.
18. Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: ESMO clinical practice guidelines. Ann Oncol, 2015, 26 Suppl 5: 152-168.
19. Schiffer CA, Mangu PB, Wade JC, et al. Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol, 2013, 31(10): 1357-1370.
20. Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: a user's guide. Pharmacoeconomics, 2008, 26(8): 661-677.
21. Pearmain D, Swanson J, Kroes E, et al. Stated preference techniques: a guide to practice (2nd ed). London: Steer Davies Gleave and Hague Consulting Group Press, 1991.
22. Train KB. Discrete choice methods with simulation (2nd edition). Cambridge: Cambridge University Press, 2009.
23. Lancsar E, Louviere J, Flynn T. Several methods to investigate relative attribute impact in stated preference experiments. Soc Sci Med, 2007, 64(8): 1738-1753.
24. 劉運江, 屈翔, 葛智成, 等. 乳腺癌植入式靜脈輸液港臨床應用專家共識及技術操作指南(2017版). 中國實用外科雜志, 2017, 37(12): 1377-1382.
25. 羅祎, 石磊, 江智霞, 等. 植入式靜脈輸液港與經外周靜脈穿刺中心靜脈置管在腫瘤化療中的應用效果評價. 中國實用護理雜志, 2015, 31(22): 1681-1685.

Chinese Journal of Evidence-Based Medicine

Preliminary analysis of preferences and willingness to pay for central venous access in patients with breast cancer

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