Evaluation of psoriasis patients’ attitudes toward benefit–risk and therapeutic trade-offs in their choice of treatments

Abstract

ObjectiveTreatment options for psoriasis offer trade-offs in terms of efficacy, convenience, and risk of adverse events. We evaluated patients’ preferences with respect to benefit–risk in the treatment of psoriasis.MethodsA discrete choice experiment was conducted in adults from the UK with moderate-to-severe psoriasis using an orthogonal design with 32 hypothetical choice sets. Participants were randomly assigned to one of two surveys with 16 choice sets. Patients’ preferences were investigated with respect to the following attributes: reduction in body surface area affected by psoriasis, treatment administration (frequency and mode of delivery), short-term diarrhea or nausea risk, and 10-year risk of developing melanoma or nonmelanoma skin cancer, tuberculosis, or serious infections. A mixed effects logistic regression model generated relative preferences between treatment profiles.ResultsParticipants (N=292) had a strong preference to avoid increased risk of melanoma or nonmelanoma skin cancer (odds ratio [OR]: 0.44 per 5% increased 10-year risk) and increased risks of tuberculosis and serious infections (both ORs: 0.73 per 5% increased 10-year risk) and preferred once-weekly to twice-daily tablets (OR: 0.76) and weekly (OR: 0.56) or fortnightly (OR: 0.65) injections. Participants preferred avoiding treatments that may cause diarrhea or nausea in the first 2 weeks (OR: 0.87 per 5% increase) and preferred treatments that effectively resolved plaque lesions (OR: 0.93 for each palm area still affected).ConclusionAll attributes were significant predictors of choice. Patients’ preference research complements clinical trial data by providing insight regarding the relative weight of efficacy, tolerability, and other factors for patients when making treatment choices.

Patient preference study for different characteristics of systemic psoriasis treatments (Protimisis)

“…Although various studies on patient preferences have been published in the past (Eliasson et al, 2017;Gutknecht, Schaarschmidt, Herrlein, & Augustin, 2016;Kromer et al, 2015;Schaarschmidt et al, 2013Schaarschmidt et al, , 2015Schmieder et al, 2012;Street, Burgess, & Louviere, 2005;Torbica, Fattore, & Ayala, 2014), there are no such published data from Greece. Although various studies on patient preferences have been published in the past (Eliasson et al, 2017;Gutknecht, Schaarschmidt, Herrlein, & Augustin, 2016;Kromer et al, 2015;Schaarschmidt et al, 2013Schaarschmidt et al, , 2015Schmieder et al, 2012;Street, Burgess, & Louviere, 2005;Torbica, Fattore, & Ayala, 2014), there are no such published data from Greece.…”

“…In addition, different patient profiles may attach importance to different treatment attributes. Although various studies on patient preferences have been published in the past (Eliasson et al, 2017;Gutknecht, Schaarschmidt, Herrlein, & Augustin, 2016;Kromer et al, 2015;Schaarschmidt et al, 2013Schaarschmidt et al, , 2015Schmieder et al, 2012;Street, Burgess, & Louviere, 2005;Torbica, Fattore, & Ayala, 2014), there are no such published data from Greece. In addition, this is the largest study (n 5 309) reported in this topic.…”

Cardiovascular risk factors predicting cardiac events are different in patients with rheumatoid arthritis, psoriatic arthritis, and psoriasis

“…Patient centred care and education means that an individual with psoriasis is informed to make a personal decision regarding their treatment and an absence of DMARD therapies in their patient record may reflect this choice, rather than a proxy for disease severity. In fact, a great dissatisfaction has been reported with current psoriasis treatment options [37][38][39], which may cause resistance to agreeing to these medications.…”

Use of Patient Preference Information in Benefit–Risk Assessment, Health Technology Assessment, and Pricing and Reimbursement Decisions: A Systematic Literature Review of Attempts and Initiatives

“…Traditionally, HTA processes have lacked the relative importance or preference of patients in relation to decision criteria and clinical endpoints (3,23). Therefore, PPs may complement clinical evidence that HTA bodies evaluate by providing more than just quality of life on specific clinical outcomes, but instead on aspects of treatment that HTA authorities would not know otherwise, such as mode and frequency of administration-which is most convenient and the influence it has on patients to prefer one treatment over another (13,26). To date, there has been little to no information regarding PP integration in HTA processes, and still, many HTA bodies worldwide recognize its importance but have yet to prioritize the methodologies and framework for including PP (3).…”