Samantha Pollard, Faculty of Health Sciences, SFU

Title: Estimating value of prognostic based assays for Lymphoid cancers: A pan-Canadian discrete choice experiment
Date: Friday, March 27th, 2026
Time: 1:00PM (PDT)
Location: ASB 10900

Abstract:
Background: Discrete choice experiments (DCEs) offer a rigorous framework for quantifying patient preferences and willingness to pay (WTP) for genomic diagnostics, yet few have been applied to lymphoid cancers where targeted therapies remain limited and prognostic-based assays are being validated for clinical uptake.

Methods: We developed a DCE through focus groups, clinical consultation, and think-aloud cognitive interviews (n=17). Attributes included test invasiveness, probability of avoiding unnecessary chemotherapy, probability of cancer recurrence, and out-of-pocket cost. Following piloting (n=151), the finalized instrument was administered to a nationally representative Canadian sample (n=1,352; n=144 with a cancer diagnosis). Preference-based utilities were estimated using a generalized multinomial logit (GMNL) model with error components to account for preference heterogeneity and scale differences across respondents.

Results: The cost coefficient was negative and significant (β = −0.054, 95% CI: −0.065, −0.043), confirming price sensitivity. WTP was $3,095.90 for a 55% improvement in probability of avoiding unnecessary treatment and $1,206.94 for a 15% improvement. Predicted uptake declined monotonically with out-of-pocket cost across scenario analyses.

Conclusions: GMNL modelling of DCE data provides interpretable, preference-weighted utility estimates and WTP thresholds directly applicable to health technology assessment and genomic testing policy in oncology. As genomic assays outpace reimbursement frameworks, preference data of this kind are essential for anticipating uptake and informing value.