Conjoint analysis to understand preferences of patients with multiple sclerosis for disease-modifying therapy attributes in Spain: a cross-sectional observational study

Abstract

ObjectiveTo assess patients’ preferences for a range of disease-modifying therapy (DMT) attributes in multiple sclerosis (MS).DesignA cross-sectional observational study.SettingThe data reported were from 17 MS units throughout Spain.ParticipantsAdult patients with relapsing-remitting MS.Main outcomeA conjoint analysis was applied to assess preferences. A total of 221 patients completed a survey with 10 hypothetical DMT profiles developed using an orthogonal design and rating preferences from 1 (most acceptable) to 10 (least acceptable). Medication attributes included preventing relapse, preventing disease progression, side effect risk, route and frequency of administration.ResultsPatients placed the greatest relative importance on the side effect risk domain (32.9%), followed by route of administration (26.1%), frequency of administration (22.7%), prevention of disease progression (10.0%) and prevention of relapse (8.3%). These results were independent of the Expanded Disability Status Scale score. The importance assigned to side effect risk was highest for patients with a recent diagnosis. Patients who had previously received more than one DMT gave a higher importance to relapse rate reduction than patients receiving their first DMT.ConclusionsPatient DMT preferences were mainly driven by risk minimisation, route of administration and treatment schedule. The risk–benefit spectrum of available DMT for MS is becoming increasingly complicated. Understanding which treatment characteristics are meaningful to patients may help to tailor information for them and facilitate shared decision-making in clinical practice.

Whose Preferences Matter? A Patient-Centered Approach for Eliciting Treatment Goals

“… 33 These treatments may differ in their effectiveness, side-effects, risks, costs, and method of administration. A search of the literature identified 5 studies and 1 DA that addressed MS treatment preferences, 34 – 39 each using a different set of attributes and all but one 38 using investigator-selected attributes without specifying the selection process.…”

The impact of the face-to-face consultation on decisional conflict in complex decision-making in multiple sclerosis: A pilot study

“…See Ref. 13 , 36 , 37 a Non-MS, b This value has been converted again as per the author’s instructions 21 to enable comparison to non-MS group, c Non-MS group with depression. …”

A new approach to pharmaceutical pricing based on patients’ willingness to pay

“…For the purposes of the study, the relevant literature [9,13,19,22,23], expert views and the results of a pilot Preparation of the syringe and lack of the need for pre-injection preparations, or drug preparation prior to injection by the patient or PWID (persons who injects drugs) study were exploited to derive the following attributes and their levels: country of origin (Iran or elsewhere), monthly treatment cost (US$: 0-33, 33-132 and 132-231), 1 administration and injection frequency (intramuscular injection, once a week; subcutaneous injection, three times a week; and subcutaneous injection, every other day), efficacy (moderate or high), side effects (low or medium) and ease of application (convenient or inconvenient). Subsequently, 12 scenarios (24 paired profiles) were created using fractional factorial to establish WTP (see Table 1).…”