Improving Patient-Centered Care by Assessing Patient Preferences for Multiple Sclerosis Disease-Modifying Agents: A Stated-Choice Experiment

Carlin, Caroline; Higuera, Lucas; Anderson, Sara E.

doi:10.7812/tpp/16-102

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…Similar to prior literature, our model showed that patients with RRMS in the UK prefer oral DMDs and infusions relative to injections 22,23,27 , as well as DMDs with less frequent administration 26 . However, our results also showed that current DMD market shares within the UK RRMS population do not reflect these patient preferences.…”

Section: Discussionsupporting

confidence: 80%

“…Given the expanding treatment options 21 , a large body of research has evolved around understanding patients' preferences for various attributes of DMDs [22][23][24][25][26][27] . These studies suggest that treatment frequency, mode of administration, and likelihood of side effects from a DMD are of importance to patients [25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

“…These studies suggest that treatment frequency, mode of administration, and likelihood of side effects from a DMD are of importance to patients [25][26][27] . Studies show that patients strongly prefer oral administration 22,23,27 , particularly when oral treatment dosing is less frequent (e.g. less than three times daily) and the treatment has infrequent side effects 26 .…”

Section: Introductionmentioning

confidence: 99%

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Modeling the impact of patient treatment preference on health outcomes in relapsing-remitting multiple sclerosis

Eijndhoven¹,

Brauer²,

Kee³

et al. 2020

Journal of Medical Economics

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Aims: Model how moving from current disease-modifying drug (DMD) prescribing patterns for relapsing-remitting multiple sclerosis (RRMS) observed in the United Kingdom (UK) to prescribing patterns based on patient preferences would impact health outcomes over time. Materials and methods: A cohort-based Markov model was used to measure the effect of DMDs on long-term health outcomes for individuals with RRMS. Data from a discrete choice experiment were used to estimate the market shares of DMDs based on patient preferences (i.e. preference shares). These preference shares and real-world UK market shares were used to calculate the effect of prescribing behavior on relapses, disability progression, and quality-adjusted life-years (QALYs). The incremental benefit of patient-centered prescribing over current practices for the UK RRMS population was then estimated; scenario and sensitivity analyses were also conducted. Results: Compared to current prescribing practices, when UK patients with RRMS were treated following patient preferences, health outcomes were improved. This population was expected to experience 501,690 relapses and gain 1,003,263 discounted QALYs over 50 years under patient-centered prescribing practices compared to 538,417 relapses and 958,792 discounted QALYs under current practices (À6.8% and þ4.6%, respectively). Additionally, less disability progression was observed when prescribed treatment was based on patient preferences. In a scenario analysis where only oral treatments were considered, the results were similar, although the magnitude of benefit was smaller. Number of relapses was most sensitive to how the annualized relapse rate was modeled; disability progression was most sensitive to mortality rate assumptions. Limitations: Treatment efficacy estimates applied to various models in this study were based on data derived from clinical trials, rather than real-world data; the impact of patient-centered prescribing on treatment adherence and/or switching was not modeled. Conclusions: The population of UK RRMS patients may experience overall health gains if patient preferences are better incorporated into prescribing practices.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Modeling the impact of patient treatment preference on health outcomes in relapsing-remitting multiple sclerosis

Eijndhoven¹,

Brauer²,

Kee³

et al. 2020

Journal of Medical Economics

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“…Obs, observations. 12 [9][10][11][12][13][14][15] 9 [6][7][8][9][10][11][12] n/a 31 [27][28][29][30][31][32][33][34][35][36] 2 [1][2][3] 18 [14][15][16][17][18][19][20][21] Historic base-case scenario, DE…”

Section: Resultsunclassified

“…7,8 Appendix A in the Supplementary Material provides a structured overview of previously published MS patient preference studies. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] This research has been informative regarding the general stance of MS patients on risk/benefit tradeoffs when choosing between DMTs. However, these studies have neglected one very important aspect, which is the analysis of patient preferences for actually available treatment profiles.…”

mentioning

confidence: 99%

Summarizing Patient Preferences for the Competitive Landscape of Multiple Sclerosis Treatment Options

et al. 2020

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Objective. Quantitatively summarize patient preferences for European licensed relapsing-remitting multiple sclerosis (RRMS) disease-modifying treatment (DMT) options. Methods. To identify and summarize the most important RRMS DMT characteristics, a literature review, exploratory physician interviews, patient focus groups, and confirmatory physician interviews were conducted in Germany, the United Kingdom, and the Netherlands. A discrete choice experiment (DCE) was developed and executed to measure patient preferences for the most important DMT characteristics. The resulting DCE data ( n=799 and n=363 respondents in the United Kingdom and Germany, respectively) were analyzed using Bayesian mixed logit models. The estimated individual-level patient preferences were subsequently summarized using 3 additional analyses: the quality of the choice data was assessed using individual-level R2 estimates, individual-level preferences for the available DMTs were aggregated into DMT-specific preference shares, and a principal component analysis was performed to explain the patients’ choice process. Results. DMT usage differed between RRMS patients in Germany and the United Kingdom but aggregate patient preferences were similar. Across countries, 42% of all patients preferred oral medications, 38% infusions, 16% injections, and 4% no DMT. The most often preferred DMT was natalizumab (26%) and oral DMT cladribine tablets (22%). The least often preferred were mitoxantrone and the beta-interferon injections (1%–3%). Patient preferences were strongly correlated with patients’ MS disease duration and DMT experience, and differences in patient preferences could be summarized using 8 principle components that together explain 99% of the variation in patients’ DMT preferences. Conclusion. This study summarizes patient preferences for the included DMTs, facilitates shared decision making along the dimensions that are relevant to RRMS patients, and introduces methods in the medical DCE literature that are ideally suited to summarize the impact of DMT introductions in preexisting treatment landscapes.

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A Targeted Literature Search and Phenomenological Review of Perspectives of People with Multiple Sclerosis and Healthcare Professionals of the Immunology of Disease-Modifying Therapies

Burtchell¹,

Clemmons

et al. 2022

Neurol Ther

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Introduction The mechanisms of action of disease-modifying therapies (DMTs) for multiple sclerosis (MS) are complex and involve an interplay of immune system components. People with MS (PwMS) may lack a clear understanding of the immunological pathways involved in MS and its treatment; effective communication between healthcare professionals (HCPs) and PwMS is needed to facilitate shared decision-making when discussing the disease and selecting DMTs and is particularly important in the coronavirus disease 2019 (COVID-19) era. Methods In this patient-authored two-part review, we performed a targeted literature search to assess the need for better communication between HCPs and PwMS regarding treatment selection, and also conducted a qualitative survey of four patient and care-partner authors to obtain insights regarding their understanding of and preferences for the treatment and management of MS. Results Following a search of the Embase and MEDLINE databases using Ovid in June 2020, an analysis of 40 journal articles and conference abstracts relating to patient empowerment and decision-making in DMT selection for MS showed a preference for safety and efficacy of treatments, followed by autonomy and convenience of administration. A need for better communication between HCPs and PwMS during treatment selection to improve patient satisfaction was also identified. The open survey responses from the patient authors revealed a need for greater involvement in decision-making processes and desire for improved communication and information tools. Conclusions This targeted literature search and phenomenological review confirms PwMS preferences for empowered decision-making in disease management and treatment selection, to optimize independence, safety, and efficacy. It also identifies an unmet need for improved communication and information tools that convey MS information in a relatable manner. Furthermore, this review seeks to address this unmet need by providing plain language figures and descriptions of MS immune mechanisms that can be used to facilitate discussions between HCPs and PwMS. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00349-5.

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Improving Patient-Centered Care by Assessing Patient Preferences for Multiple Sclerosis Disease-Modifying Agents: A Stated-Choice Experiment

Cited by 9 publications

References 9 publications

Modeling the impact of patient treatment preference on health outcomes in relapsing-remitting multiple sclerosis

Modeling the impact of patient treatment preference on health outcomes in relapsing-remitting multiple sclerosis

Summarizing Patient Preferences for the Competitive Landscape of Multiple Sclerosis Treatment Options

A Targeted Literature Search and Phenomenological Review of Perspectives of People with Multiple Sclerosis and Healthcare Professionals of the Immunology of Disease-Modifying Therapies

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