Patients' preferences in periodontal disease treatment elicited alongside an IQWiG benefit assessment: a feasibility study

Abstract

Background and purposeThe German Institute for Quality and Efficiency in Health Care (IQWiG) previously tested two preference elicitation methods in pilot projects and regarded them as generally feasible for prioritizing outcome-specific results of benefit assessment. The present study aimed to investigate the feasibility of completing a discrete choice experiment (DCE) within 3 months and to determine the relative importance of attributes of periodontal disease and its treatment.Patients and methodsThis preference elicitation was conducted alongside the IQWiG benefit assessment of systematic treatments of periodontal diseases. Attributes were defined based on the benefit assessment, literature review, and patients’ and periodontologists’ interviews. The DCE survey was completed by patients with a history of periodontal disease. Preferences were elicited for the attributes “tooth loss within next 10 years”, “own costs for treatment, follow-up visits, re-treatment”, “complaints and symptoms”, and “frequency of follow-up visits”. Patients completed a self-administered questionnaire including 12 choice tasks. Data were analyzed using a random parameters logit model. The relative attribute importance was calculated based on level ranges.ResultsWithin 3 months, survey development, data collection among 267 patients, data analysis, and provision of a study report could be completed. The analysis showed that tooth loss (score 0.73) was the most important attribute in patients’ decisions, followed by complaints and symptoms (0.22), frequency of follow-up visits (0.02), and costs (0.03) (relative importance scores summing up to 1).ConclusionA preference analysis performing a DCE can be generally feasible within 3 months; however, a good research infrastructure and access to patients is required. Outcomes used in benefit assessments might need to be adapted to be used in preference analyses.

<p>Patient preferences for glucagon-like peptide-1 receptor&ndash;agonist treatment attributes</p>

“…Two studies were multinational. DCEs were employed for preference elicitation in six studies,15,17–20,23 two studies used TTO,12,21 one reported a DCE with WTP,24 and one study used both TTO and DCE 22. Sample sizes ranged from 182 to 1,482 participants, and all studies included adults with T2DM.…”

“…Three studies used a TTO approach 12,21,22. In the earliest of these, patients with T2DM were presented with a pair of product profiles representing liraglutide once daily and exenatide twice daily 22.…”

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

“…It has been estimated that it takes from 6 months to 2 years to conduct a PP study, with recruitment of patients taking particularly longer than predicted (3). Guidelines should consider developing timeframes for conducting PP studies (11). Some have suggested that 3 months is an ample window of time to dedicate to PP study for decision-making inclusion and that time constraints should not be the driver as to whether systematic integration of PPs in regulatory decision making occurs (11).…”

“…Guidelines should consider developing timeframes for conducting PP studies (11). Some have suggested that 3 months is an ample window of time to dedicate to PP study for decision-making inclusion and that time constraints should not be the driver as to whether systematic integration of PPs in regulatory decision making occurs (11). It is also not clear when in the decision-making processes of either BRAs or HTAs PP elicitation and PP studies should be conducted and submitted (3).…”

“…While the role of patient with regard to microlevel decision, i.e., shared decision making, has significantly evolved in the last decades, when it comes to health authorities' decision making, the relative importance of patient voice remained unclear. Recently, health technology assessment (HTA) organizations, regulatory agencies, and decision-making bodies largely have started to explore opportunities for incorporation of patients' perspective in their decisions (1,3,11,12). Furthermore, patients are claiming this greater role in healthcare decision making (3,5,12,13).…”