Patients’ preferences for accepting risks and uncertainty in AML treatments within European public health care systems: a cross-sectional study in Finland, Italy, and Germany

The aim of this study was to identify what tradeoffs patients with acute myeloid leukemia (AML) are willing to make between different treatment attributes when choosing between chemotherapy and novel targeted therapies involving higher uncertainty, within the context of European publicly funded health‑care systems. A survey with a probabilistic threshold technique and a ranking exercise were distributed to patients with AML in Finland, Germany, and Italy. Respondents (n = 68) were presented with two treatment options described by six attributes. Interval regressions were used to analyze the threshold intervals for each attribute. Mean threshold values for accepting targeted treatment were 82% chance of complete remission, 48% risk of short-term side effects, 10% for long-term side effects, and two weeks for treatment time in hospital. Preference heterogeneity was identified. Complete remission was ranked most important followed by scientific evidence and risk of long-term side effects.