Patient preferences for attributes of disease modifying Therapies: Results of a choice based conjoint analysis

Abstract

A107 RESULTS: Patients (n=660, 100% completion rate) completed the survey. All attributes were significant predictors of choice except sleepiness. Respondents were significantly more likely to choose a treatment that provided a 10% reduction in seizure frequency (Odds Ratio [OR]=1.75, 95% CI 1.68-1.82) or avoided weight gain (3lb) (OR=0.751, 95% CI=0.731-0.772). Respondents were willing to pay an additional £39 and £20 per month for AEDs with those attributes. Furthermore, respondents who become unresponsive during a seizure placed higher levels of preference on an AED that would reduce seizure frequency. Respondents who reported higher levels of adherence to their AEDs (MMAS-8) reported better quality of life (QoL) (QOLIE-31-P and EQ-5D-5L). CONCLUSIONS: Seizure reduction is the most important AED attribute to epilepsy patients, but lack of weight gain is also valued. Higher adherence to AEDs appears to be linked with improved QoL.

Quantitative analysis of multiple sclerosis patients’ preferences for drug treatment: a best–worst scaling study

“…Likewise, recent studies of preferences of patients with MS suggest that route and frequency of administration were important treatment attributes, with oral treatments being preferred to injections when treatment frequency and frequency of side effects were held constant [Utz et al 2014;Wilson et al 2015]. Our findings concur with those of Wilson and colleagues, suggesting that prevention of relapse was not as important as improving symptoms and preventing SAEs [Wilson et al 2015].…”

“…It is reasonable to believe that some patients might rather be dead than have their disease progress to the point of total dependence and the potential loss of dignity [Griebsch et al 2005]. Nevertheless Wilson and colleagues and Utz and colleagues used small and nonrepresentative samples, only included patients with RRMS, only reported average preferences for the sample thus assuming preference homogeneity, and applied a DCE and choice-based conjoint analysis experiment, respectively [Utz et al 2014;Wilson et al 2015]. While a discrete choice experiment (DCE) approach could be used in our study to elicit preferences, it has been suggested that a better methodological approach to eliciting 'relative' preferences both between levels of a given attribute and across attributes is by using a BWS methodology [Marley and Louviere, 2005;Flynn et al 2007Flynn et al , 2008Marley et al 2008;Potoglou et al 2011].…”

Preferences for Multiple Sclerosis Treatments

“…Only two previous studies compared oral, injection, and intravenous (IV) therapies, and in these studies, IV therapy was described as being administered every month. 9,10 The existing studies do not include DMT options under development that offer different efficacy/safety profiles and administration and dosing options.…”

“…Over the range of levels included in this survey, respondents who rated their disability level as normal or mild placed greater weight on the mode and frequency of administration and the risk that their MS progressed in the next year than on the risk of serious infection and nausea attributes. Patients with moderate or worse disability placed the most 10 The survey text specified that relapses can sometimes lead to a permanent increase in disability (Table 1) and were instructed to assume that they would return to their baseline disability level after the relapse ended. Given the importance of reducing the risk of permanent worsening of the disease, preferences for avoiding relapses might have been stronger if the respondents had been instructed that relapses would result in a permanent increase in disability.…”

The clinical perspective: How to personalise treatment in MS and how may biomarkers including imaging contribute to this?

“…However, delaying disability progression remains the most important treatment expectation for patients, being more important than preventing SAEs and decreasing relapse rate ( Figure 5). 112,113 Hence, it is not surprising that patients might be more willing to accept SAEs in return for a reduced risk of disability progression than physicians. 114 Given these differences in treatment perspectives between patients and physicians, neurologists should strongly encourage their patients to formulate their own values and preferences regarding their medical care.…”