A discrete choice experiment to assess patients’ preferences for HIV treatment in the urban population in Colombia

Abstract

Aim: This study aimed to assess patients' preferences for HIV treatment in an urban Colombian population. Methods: A Discrete Choice Experiment (DCE) was conducted. Urban Colombian HIV patients were asked to repetitively choose between two hypothetical treatments that differ in regard to five attributes 'effect on life expectancy', 'effect on physical activity', 'risk of moderate side effects, 'accessibility to clinic' and 'economic cost to access controls'. Twelve choice sets were made using an efficient design. A Mixed Logit Panel Model was used for the analysis and subgroup analyses were performed according to age, gender, education level and sexual preference. Results: A total of 224 HIV patients were included. All attributes were significant, indicating that there were differences between at least two levels of each attribute. Patients preferred to be able to perform all physical activity without difficulty, to have large positive effects on life expectancy, to travel less than 2 h, to have lower risk of side-effects and to have subsidized travel costs. The attributes 'effect on physical activity' and 'effects on life expectancy' were deemed the most important. Sub-analyses showed that higher educated patients placed more importance on the large positive effects of HIV treatment, and a more negative preference for subsidized travel cost (5% level). Limitations: A potential limitation is selection bias as it is difficult to make a systematic urban/rural division of respondents. Additional, questionnaires were partly administered in the waiting rooms, which potentially led to some noise in the data. Conclusions: Findings suggests that short-term efficacy (i.e. effect on physical activity) and long-term efficacy (i.e. effect on life expectancy) are the most important treatment characteristics for HIV urban patients in Colombia. Preference data could provide relevant information for clinical and policy decision-making to optimize HIV care.

A discrete choice experiment to assess patients’ preferences for HIV treatment in the rural population in Colombia

“…Furthermore, a similar DCE study conducted in the urban population of Bogota showed similar results 33 . Both urban and rural populations deemed the attributes "effect on physical activity" and "effects on life expectancy" as most important.…”

Patients’ preferences for antiretroviral therapy service provision: a systematic review

“…Our data comprised of seven studies from the African region [ 34 – 40 ], 10 in the Americas [ 23 , 41 – 49 ], five in Europe [ 50 – 54 ], and one in both the Americas and Europe (USA and Germany) [ 55 ]. Sixteen studies were quantitative [ 23 , 34 , 36 , 38 , 40 , 41 , 43 , 44 , 46 – 48 , 51 – 55 ] and three were qualitative [ 35 , 39 , 42 ]. Four articles reported both qualitative and quantitative findings [ 37 , 45 , 49 , 50 ].…”

“…Patients’ preferences were elicited with DCE/conjoint analysis method in 12 studies [ 23 , 34 , 36 – 38 , 40 , 43 , 46 , 48 , 50 , 52 , 54 ]; rating exercise [ 47 , 51 ], ranking exercise [ 49 ] and adaptive conjoint analysis [ 41 , 55 ] in two studies each; and pair-wise comparison [ 45 ], and Best–Worst Scaling 1 [ 44 ] in one study each (Table 2 ).…”

Understanding patients’ preferences for HIV treatment among rural and urban Colombian patients

“…In this issue of the Journal of Medical Economics (August 2020), Goossens et al 8 and Sijstermans et al 9 reported on DCEs conducted to assess patients' preferences for HIV treatment in rural and urban Colombia. Five attributes were derived from literature review and a focus group with patients: "effect on life expectancy," "effect on physical activity," "risk of moderate side effects," "accessibility to clinic" and "economic cost to access controls".…”

“…Next to rural versus urban differences, it is important to consider the different modes of administration of ART, which could be delivered orally as well as via injection. The studies of Goossens et al 8 and Sijstermans et al 9 did not include mode of administration, which means that more research is needed to identify potential differences in preferences between modes of administration. Recently, in the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) and Assessment of ibrutinib plus rituximab in front-line CLL (FLAIR) trials, monthly ART injection was shown to be noninferior to continuing current daily threedrug oral ART 14 .…”