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

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 five years and 2,048 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 four 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 (LCA) 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 ($5,985). 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. LCA 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.