Objective: To assess variability in patients' values and preferences r
egarding cholesterol-lowering therapy. Design: A descriptive study. Pa
tients currently receiving cholesterol-lowering therapy were interview
ed using the time tradeoff and standard reference gamble techniques of
utility assessment. Setting: Internal medicine clinics of a military
medical center. Participants: Thirty-five patients, clinically free of
coronary disease, receiving cholesterol-lowering therapy for at least
three months. Results: When the time tradeoff method was applied, 12
(34%) of the patients indicated that less than one month of additional
life would be a fair return for adhering to their current therapy for
the rest of their lives, while 13 (37%) patients required more than o
ne additional year of life, and four (11%) required at least five year
s. By the standard reference gamble method, 18 (51%) patients would no
t have accepted a risk of one in a thousand of imminent death (in 30 d
ays) in hopes of obtaining a normal life expectancy off therapy, while
14 (40%) would have agreed to a 1% or greater risk in order to avoid
therapy. Conclusions: While many patients apparently expected very lit
tle in return for adhering to therapy, many others may not be getting
''what they bargained for. ''