Understanding how out-of-pocket expenses, treatment value, and patient characteristics influence treatment choices

• DOI: 10.1200/jco.2009.27.15_suppl.e20543
• Publication Date: 2020-08-25T20:19:54Z
• Authors: Y. Wong; O. Hamilton; B. Egleston; K. Salador; C. Murphy; N. J. Meropol
• Keywords: Demographics

e20543 Background: Cost-sharing is a method to control “over-use” of healthcare services but may have the unintended consequence reducing utilization necessary among vulnerable patients (pts). It not known if cost influences pts’ choices cancer treatments. Methods: A survey was administered convenience sample pts on surveillance for localized cancer. Domains included demographic questions as well clinical scenarios elicit maximum co-payment would be willing pay hypothetical Scenario described adjuvant therapy; varied reductions in recurrence rates from 5–20%. B palliative 2-year survival between 19–34%. C improvement median life expectancy 11–20 months. GEE fit multiple logistic regressions examined characteristics associated with willingness (WTP). Pts chose 9 levels (highest: >$7,000/6 months A; >$1,000/3 weeks Scenarios B-C), which were dichotomized (highest 5 vs lowest 4 levels). Results: 60 completed survey. Demographics: Female (78%); < 65 (83%), Caucasian (97%), college degree (58%). 13% reported making financial sacrifices treatment. Overall, showed greater WTP more effective treatments (p<0.05 all 3 scenarios). In B, who currently working demonstrated (OR 12.6 95% CI 2.0 -80.4) when controlling efficacy. C, 5.0, 96% 1.2–20.9). addition, having make previous care lower 0.2 95%CI 0.04–0.6). Conclusions: assign higher value Even this relatively young, affluent and educated group, variables WTP. Larger studies diverse populations are required further elucidate how influence pts'treatment contribute health disparities. These findings inform policy by suggesting benefit plans that use sharing optimize limited resources without compromising access needed care. [Table: see text]