The Value of Hope in Cancer Care: Risk Preference and Heterogeneity in Cancer Patients and the General Public.

Abstract

Objectives: To quantify the value of hope in cancer care and examine age as a potential modifier, comparing patients and the general public.

Methods: A discrete choice experiment was conducted in 2024 with 426 cancer patients diagnosed within the past 5 years and 2048 general public members without prior cancer experience in South Korea. Choice options comprised treatment effects, health status, and out-of-pocket costs. Treatment effects included a fixed 2-year survival option and 4 risk options offering 10% chances of extended survival (5 or 10 years) paired with 10% chances of minimum survival (3 months or 1 year), with varying survival durations for the remaining 80% to yield the same expected survival. Each participant completed 10 choice tasks, repeated for hypothetical ages of 5 and 70. Mixed logit and latent class analyses were performed.

Results: Both groups, particularly cancer patients, positively valued treatments with 10% chances of 10-year and 1-year survival over certainty. The monetary value of hope for this option was $12 445 for patients, about double that for the general public ($5985). These values increased to $51 103 and $35 609, respectively, for age 5, but were much lower for age 70. Conversely, the certainty option was preferred over treatments with 10% chances of 5-year and 3-month survival. Latent class analyses revealed substantial preference heterogeneity.

Conclusions: The value of hope represents a meaningful aspect of treatment preferences, especially in pediatric contexts. However, substantial preference heterogeneity poses challenges to effectively incorporating hope into health technology assessments, particularly in publicly funded healthcare systems.