Treatment Preferences for Acute Myeloid Leukemia in Harbin, China: A Discrete Choice Experiment Among Patients, Caregivers, and Hematologists.

OBJECTIVE: This study aimed to quantify the preferences and trade-offs of Chinese patients with acute myeloid leukemia (AML), primary caregivers, and hematologists regarding key treatment attributes, and to explore heterogeneity in preferences across and within groups. METHODS: A discrete choice experiment with five attributes (complete remission rate, quality of life during treatment, long-term side effects, route of administration, and monthly treatment cost) was conducted. Between November 2025 and February 2026, patients with AML and their caregivers were recruited from two tertiary hospitals in Harbin, China; hematologists were recruited via an online survey. Preference weights were estimated using conditional logit models. Relative attribute importance and willingness to pay (WTP) were calculated, and preference heterogeneity was examined using a hierarchical Bayes model. RESULTS: In total, 109 patients, 112 caregivers, and 85 hematologists were included. All three groups ranked complete remission rate as the most important attribute. Hematologists' WTP for an improvement in remission rate from 65% to 80% (CNY 50,410) was approximately twice that of patients (CNY 25,890) and caregivers (CNY 23,360). Preference weights and WTP for quality of life during treatment were comparable across groups. Patients and caregivers placed greater relative importance on monthly treatment cost (both 21%) than did hematologists (17%). Probability simulations showed that patients and caregivers shifted more strongly toward regimens with more favorable quality-of-life and side-effect profiles as these advantages increased, whereas hematologists showed a smaller change in choice probability. Subgroup analyses indicated that income, prior treatment experience, education level, and residential area were significant sources of preference heterogeneity among patients and caregivers. CONCLUSIONS: AML patients, caregivers, and hematologists consistently prioritized treatment efficacy but differed in the trade-offs made between remission benefit and economic burden. Shared decision making in AML should integrate quality of life, economic affordability, and long-term side effects, and account for individual variation in patient and family values.