Table 4.
Preferences for adjuvant immunotherapy relative to no adjuvant immunotherapy in resected stage III melanoma, MMNL model (n = 116)*
| Variable | Coefficient | Post-estimation odds ratio, mean, 95% CI | p-value | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| All n = 116 |
Imm n = 75 |
Imm tox n = 17 |
No Imm n = 22 |
All n = 116 |
Imm n = 75 |
Imm tox n = 17 |
No Imm n = 22 |
All n = 116 |
Imm n = 75 |
Imm tox n = 17 |
No Imm n = 22 |
|
| Non-random parameters (n = 3) | ||||||||||||
| 3-Weekly drug regimen (base value 4-weekly) | – 0.07 | 0.11 | – 1.31 | – 0.37 |
0.94, 0.54–1.63 |
1.11, 0.55–2.24 |
0.27, 0.63–1.87 |
0.69, 0.10–4.72 |
0.82 | 0.76 | 0.17 | 0.71 |
| Chance of mild AE (base value 37%) | ||||||||||||
| 1% | 0.72 | 0.16 | 2.46 | 3.69 |
2.06, 1.13–3.78 |
1.17, 0.58–2.38 |
11.71, 1.53–89 |
39.93, 0.83–1920 |
0.02^ | 0.66 | 0.02^ | 0.06 |
| 12% | 0.90 | 0.60 | 0.96 | 2.50 |
2.46, 0.99–6.09 |
1.82, 0.58–5.67 |
2.60, 0.16–42.57 |
12.12, 0.27–545 |
0.05 | 0.30 | 0.50 | 0.20 |
| Random parameters (n = 12) | ||||||||||||
| Chance of 3-year melanoma recurrence | – 0.27 | – 0.33 | – 0.35 | – 0.43 |
0.76, 0.70–0.83 |
0.72, 0.63–0.82 |
0.71, 0.54–0.92 |
0.65, 0.45–0.94 |
0.00# | 0.00# | 0.00# | 0.02^ |
| SD | 0.16 | 0.19 | 0.00 | 0.32 | ||||||||
| Chance of permanent AE | – 0.06 | – 0.03 | – 0.27 | – 0.24 |
0.94, 0.89–0.99 |
0.97, 0.91–1.04 |
0.77, 0.61–0.96 |
0.79, 0.58–1.07 |
0.05^ | 0.39 | 0.02^ | 0.13 |
| SD | 0.10 | 0.02 | 0.10 | 0.68 | ||||||||
| Chance of fatal AE | – 0.52 | – 0.49 | – 0.79 | – 1.66 |
0.60, 0.44–0.80 |
0.61, 0.44–0.86 |
0.46, 0.15–1.38 |
0.19, 0.03–1.30 |
0.00# | 0.00# | 0.16 | 0.09 |
| SD | 0.78 | 0.68 | 1.18 | 2.09 | ||||||||
| Respondent out-of-pocket cost per year | ||||||||||||
| Cost-low income (per AU$1000)a | – 0.17 | – 0.15 | – 0.3 | – 0.79 |
0.63, 0.47–0.85 |
0.62, 0.43–0.90 |
1.18, 0.74–1.89 |
0.07, 0.00–0.94 |
0.00# | 0.01^ | 0.10 | 0.04^ |
| SD | 0.00 | 0.00 | 3.16 | 0.00 | ||||||||
| Cost-high income (per AU$1000)a | – 0.46 | – 0.48 | 0.78 | – 2.65 |
0.84, 0.15–4.86 |
0.86, 0.69–1.07 |
2.08, 0.86–5.01 |
2.20, 0.95–5.11 |
0.06 | 0.15 | 0.94 | 0.86 |
| SD | 0.00 | 0.00 | 0.00 | 0.00 | ||||||||
| Constant | – 0.23 | – 3.94 | 2.58 | −14.97 | ||||||||
| Gender | – 2.27 | – 2.13 | – 0.30 | 4.20 |
0.10, 0.02–0.65 |
0.12, 0.02–0.93 |
0.74, 0.01–51.12 |
66, 0.02–267,715 |
0.02^ | 0.04^ | 0.86 | 0.32 |
| SD | 0.35 | 0.00 | 0.59 | 3.72 | ||||||||
| Age | 0.00 | 0.03 | 0.10 | 0.36 |
1.00, 0.93–1.08 |
1.03, 0.94–1.14 |
1.11, 0.95–1.28 |
1.44, 0.93–2.23 |
0.94 | 0.49 | 0.35 | 0.11 |
| SD | 0.04 | 0.05 | 0.10 | 0.00 | ||||||||
| Children | 1.35 | 1.28 | 3.22 | −6.81 |
3.86, 0.58–25.75 |
3.59, 0.28–45.80 |
2.42, 0.00–2194 |
25.11, 0.01–51,848 |
0.16 | 0.33 | 0.80 | 0.12 |
| SD | 2.14 | 0.09 | 2.07 | 5.74 | ||||||||
| Variable | Coefficient | Post-estimation odds ratio, mean, 95% CI | p-Value | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Melanoma substage (base group IIID, most severe disease) | All n = 116 |
Imm n = 75 |
Imm tox n = 17 | No Imm n = 22 | All n = 116 |
Imm n = 75 |
Imm tox n = 17 |
No Imm n = 22 |
All n = 116 |
Imm n = 75 |
Imm tox n = 17 | No Imm n = 22 |
| IIIA (least severe disease) | 0.59 | 0.87 | NRb | – 4.24 |
1.81, 0.14–23.19 |
2.39, 0.15–39.13 |
NR |
0.01, 0–51,602,630 |
0.65 | 0.54 | NR | 0.70 |
| SD | 2.41 | 1.51 | NRb | 2.51 | ||||||||
| IIIB/IIIC (mid- to severe disease) | 1.09 | 0.81 | NRb | 3.65 |
2.98, 0.41–21.44 |
2.24, 0.23–22.34 |
NR |
0.44, 0–630 |
0.28 | 0.49 | NR | 0.70 |
| SD | 0.98 | 0.39 | NRb | 8.62 | ||||||||
|
Respondents with low incomea,c ≤ AU$87,999 |
– 0.19 | 3.32 | – 8.03 | – 5.59 |
0.83, 0.02–31.01 |
27.68, 0.94–816 |
0.00, 0–50.69 |
0.00, 0–0.01 |
0.92 | 0.05 | 0.05^ | 0.50 |
| SD | 3.16 | 0.40 | 3.16 | 0.63 | ||||||||
|
Respondents with high incomea,c ≥ AU$88,000 |
1.69 | 2.37 | 13.44 | 0.40 |
5.42, 0.81–36.22 |
10.71, 0.40–290 |
686,938, 89–5,283,169,295 |
38.45, 0–4,146,204,606 |
0.08 | 0.16 | 0.08 | 0.96 |
| SD | 0.46 | 0.08 | 0.00 | 1.41 | ||||||||
Two of the 116 respondents did not report if they received immunotherapy
Goodness of fit measures: log-likelihood function = – 446.78, McFadden pseudo-R2 = 0.53, AIC/N = 0.68
AE adverse event, AU Australian, CI confidence interval, NR not reported, SD standard deviation, All total sample; Imm, respondents who received immunotherapy, Imm tox respondents who ceased immunotherapy because of toxicity, No Imm respondents not receiving immunotherapy
#Significant at 1% level, p ≤ 0.01
^Significant at 5% level, p ≤ 0.05
aCost parameters used a constrained triangular distribution
bMelanoma substage group are not reported as no respondents receiving adjuvant immunotherapy and ceasing treatment due to toxicity identified as stage IIIA melanoma
cInteraction of the respondents’ out-of-pocket costs and annual pre-tax household income
Random parameters reported standard deviations. Values of 89 and above are reported with no decimal places