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. 2023 Mar;12(5):6105-6116.
doi: 10.1002/cam4.5336. Epub 2022 Nov 14.

Cancer treatments touch a wide range of values that count for patients and other stakeholders: What are the implications for decision-making?

Cilla E J Vrinzen  1   2 , Haiko J Bloemendal  3 , Esra Stuart  1 , Amr Makady  4 , Michel van Agthoven  4 , Mariska Koster  4 , Matthias A W Merkx  1   2 , Rosella P M G Hermens  1 , Patrick P T Jeurissen  1
Affiliations

Cancer treatments touch a wide range of values that count for patients and other stakeholders: What are the implications for decision-making?

Cilla E J Vrinzen et al. Cancer Med. 2023 Mar.

Abstract

Background: Cancer rates and expenditures are increasing, resulting in debates on the exact value of this care. Perspectives on what exactly constitutes worthwhile values differ. This study aims to explore all values-elements regarding new oncological treatments for patients with cancer and all stakeholders involved and to assess their implications in different decision-making procedures.

Method: Thirty-one individual in-depth interviews were conducted with different stakeholders to identify values within oncology. A focus group with seven experts was performed to explore its possible implications in decision-making procedures.

Results: The overarching themes of values identified were impact on daily life and future, costs for patients and loved ones, quality of life, impact on loved ones, societal impact and quality of treatments. The expert panel revealed that the extended exploration of values that matter to patients is deemed useful in patient-level decision-making, information provision, patient empowerment and support during and after treatment. For national reimbursement decisions, implications for the broad range of values seems less clear.

Conclusion: Clinical values are not the only ones that matter to oncological patients and the stakeholders in the field. We found a much broader range of values. Proper recognition of values that count might add to patient-level decision-making, but implications for reimbursement decisions are less clear. The results could be useful to guide clinicians and policymakers when it comes to decision-making in oncology. Making more explicit which values counts for whom guarantees a more systematic approach to decision-making on all levels.

Keywords: clinical decision-making; decision-making; neoplasms; patient preference; quality improvement; quality of life; shared.

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Conflict of interest statement

The study was partly funded by Janssen‐Cilag B.V., Breda, the Netherlands. CV, PJ, ES, MM, HB and RH have no conflict of interest to declare. AM, MK and MA are employees of Janssen‐Cilag B.V. and MA is a stock shareholder.

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