A Multinational Study to Measure the Value that Patients with Cancer Place on Improved Emesis Control Following Cisplatin Chemotherapy George Dranitsaris, 1,2 Pauline Leung, 1 Renoto Ciotti, 3 Ana Ortega, 4 Maria Spinthouri, 5 Lycurgus Liaropoulos, 5 Roberto Labianca 6 and Antonello Quadri 6 1 Department of Pharmaceutical Services, University Health Network/Princess Margaret Hospital, Toronto, Ontario, Canada 2 Molecular Biology, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Ontario, Canada 3 Department of Medical Oncology, Azienda Ospedaliera, Treviglio, Italy 4 Servicio de Farmacia, Clinica Universitaria de Navarra, Pamplona, Spain 5 Center for Health Services Management and Evaluation, University of Athens, Athens, Greece 6 Azienda Ospedaliera, Ospedali Riuntiti di Bergamo, Bergamo, Italy Abstract Background: The neurokinin-1 (NK1) receptor antagonists are a new class of agents designed to reduce the risk of emesis following chemotherapy, particularly with cisplatin. Early data from double-blind randomised trials suggest that an orally administered NK1 antagonist can reduce the absolute risk of acute and delayed emesis following cisplatin by 20 and 30%, respectively. Objective: To measure the value that patients with cancer place on improved emesis control and quality of life. Design: Willingness-to-pay analysis. Setting: Five study sites in Canada, Italy, Spain and Greece. Patients and participants: 245 patients with cancer either receiving chemother- apy with cisplatin or who had received cisplatin-based chemotherapy within the previous 6 months. Methods: After background information had been presented, patients were asked to define the maximum that they would pay per day for a drug that reduced their risk of acute and delayed (days 2 to 5) emesis by 20 and 30%, respectively. Costs were converted to US dollars ($US) using year 2000 exchange rates. Results: For a 20% improvement in acute emesis, Canadian, Italian and Spanish patients with cancer were willing to pay $US46, $US34 and $US63 per day, respectively, compared with $US8 for patients from Greece (p < 0.001). For a 30% improvement in delayed emesis, Canadian, Italian and Spanish patients with cancer were also willing to pay more than their Greek counterparts ($US41, $US31, $US50 and $US9 daily for 4 days, respectively; p < 0.001). These sig- nificant differences in patient value between countries remained, even after ad- justing for socioeconomic variables and previous history of emesis. Conclusions: There are substantial cultural differences in how patients with can- ORIGINAL RESEARCH ARTICLE Pharmacoeconomics 2001; 19 (9): 955-967 1170-7690/01/0000-0955/$22.00/0 © Adis International Limited. All rights reserved.