Preferences of patients and physicians concerning treatment options for relapsed follicular lymphoma: a discrete choice experiment.

The purpose of this study was to elicit relative preferences for common treatment options of relapsed follicular lymphoma, and their associated attributes, amongst lymphoma patients in Alberta, and lymphoma-treating physicians in Canada, using a discrete choice experiment (DCE). Treatment administration, toxicity, survival free of relapse and cost were the attributes evaluated for four treatment options: standard chemotherapy (CT), radioimmunotherapy (RIT), high-dose CT and auto-SCT, and allo-SCT. For the 81 patients and 48 physicians who participated in this study, survival free of relapse was a positive influence on choice (P<0.001), whereas negative influences on choice included toxicity of allo-SCT (P<0.001 for patients, P=0.005 for physicians) and cost (P=0.001 for physicians only). The estimated uptake of the treatment options for patients was as follows: auto-SCT (69%), RIT (14%), CT (11%) and allo-SCT (7%). The distribution for physicians was similar (56, 20, 19 and 4%, respectively). In conclusion, patients with relapsed follicular lymphoma are able to consider the different attributes of various treatment options and are willing to trade off the need for hospitalization, associated toxicity and cost associated with autologous transplantation in order to benefit from an increased PFS.