Purpose: Patients with cancer perceive chemotherapy-induced nausea and vomiting (CINV) among the most distressing side effects of chemotherapy. Recently, new antiemetic agents such as aprepitant and palonosetron have been approved which provide better control of CINV as compared to the standard regimen of 5-HT3 receptor antagonist and corticosteroid. The objective of this study was to measure the value that cancer patients place on improved emesis control provided by new antiemetic regimens.

Methods: The contingent valuation approach was used to measure patients' willingness-to-pay (WTP) for improved emetic control due to regimen A (aprepitant with standard regimen) and regimen B (palonosetron). Face to face interviews were conducted with 120 cancer patients who were 18 years or older, were currently receiving or had received chemotherapy in the past three months in an outpatient setting. After background information had been presented, participants were asked to state the maximum amount that they would pay out-of-pocket for the additional benefit provided by regimen A and B using the payment card method.

Results: Almost 82% of participants were either receiving their second or later cycles of chemotherapy or had received it in the past three months. On a scale of 0 to 10, the perceived level of importance for benefits provided by regimen A for the acute and delayed phases were 8.8 (SD=1.7) and 9.2 (SD=1.5), respectively; and by regimen B for the delayed phase was 8.6 (SD=1.6). Approximately 91% of the participants were willing to pay for the new antiemetic regimens. For a 3-day course of regimen A, providing 13% improvement in acute and 18% improvement in delayed emesis, the mean WTP was $90 (SD=$101.9). The mean WTP for a single injection of regimen B for a 12% improvement in delayed emesis was $84 (SD=$94.5). Multivariate analyses conducted to identify relationships between WTP and socio-demographic and clinical variables showed that only annual household income was significantly associated with WTP.

Conclusions: This study is among the first to evaluate perceived level of importance and WTP estimates for improved emesis control due to new antiemetic regimens among cancer patients in the United States. The study results indicate that cancer patients perceive improvements in the control of nausea and vomiting as important and are willing to pay out-of-pocket to receive the additional antiemetic benefits.