What do Australian patients with inflammatory arthritis value in treatment? A discrete choice experiment

Abstract

Background and objectives The purpose of this study was to develop an understanding of treatment preferences in patients with inflammatory arthritis (IA) [rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA)] focussing on treatment attributes that patients' value, their relative importance, and the risk-benefit trade-offs that characterise patients' choices around treatment. Methods A discrete choice experiment (DCE) approach was used. Attributes of interest were clinical efficacy; slowing of disease progression; risk of mild-moderate side effects; risk of severe side effects; frequency of administration; real-world product evidence; management of related conditions; and availability of a patient support programme. Using data from the DCE component, a restricted latent class model (LCM) was estimated to determine discrete 'classes' of treatment preferences. Results In this analysis, 206 participants were included (AS n = 59; PsA n = 62; RA n = 85). Two classes were identified. For 'class 1' (59.9%), the most important attributes (across all treatment modalities) were preventing disease progression, clinical efficacy and risk of mild-to-moderate side effects. For 'class 2' (40.1%), clinical and non-clinical attributes were important, and attribute importance depended on treatment modality. Patient demographic and treatment characteristics did not predict class membership. Conclusion For most patients with IA, clinical efficacy, stopping disease progression and risks of mild-to-moderate side effects are important treatment attributes. Patients with prior biologic DMARD experience had greater preference for injection treatments. For a subset of patients, patient support programmes and the frequency of administration were important. Clinicians should be mindful of preferences when prescribing treatment to patients with IA. Key Points • Most patients consider clinical efficacy, stopping disease progression and the risk of mild-to-moderate side effects as important treatment attributes • Patients with prior biologic DMARD experience have greater preference for injection treatments. • For a subset of patients, patient support programmes, and the frequency of administration were important. • Clinicians should be mindful of preferences when prescribing treatment to patients with IA.

Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment

“…Due to differences in nature and characteristics of the disease, the results may not represent the preferences of patients with other types of chronic diseases. Although prior DCEs [44][45][46][47][48] made conclusions that were similar to ours in terms of the relative importance of technology attributes regarding benefits and risks. Future studies need to enrol patients with other diseases and conduct subgroup analyses to identify variations in patients' preferences across different types of diseases.…”

“…Comparison with other studies Our findings of patients valuing the effectiveness and safety of medical technologies were consistent with the results by prior studies from other countries which aimed to investigate patients' preferences for the treatment of chronic diseases. [44][45][46][47][48] Our study confirmed that new technologies that could increase health benefits and minimise potential risks were preferred by patients.…”

Systematic review of quantitative preference studies of treatments for rheumatoid arthritis among patients and at-risk populations

“…Treatment attributes mainly included frequency and route of administration either as individual attributes or as a combination. In one study, a labelled experimental design was used, with the treatment profiles indicated as ‘oral’, ‘injection’, ‘infusion’ and an opt out [ 33 ].…”

“…Attributes that characterise the degree of certainty around the benefits or risk of treatment were included in two out of three prevention studies [ 45 , 46 ] and one out of two RA treatment studies with general public participants [ 43 ]. Three RA treatment studies with patient participants included attributes relating to how long a treatment has been in use [ 28 , 30 , 33 ]. There was variation across these studies in terms of the relative importance of this kind of attributes.…”

Social distancing and store choice in times of a pandemic

“…The LCL model has been applied in many settings. Some examples include preference for residential location ( Walker and Li, 2007 ), medical procedures ( Ho et al, 2020 ; Rozier et al, 2019 ), transportation mode ( El Zarwi et al, 2017 ; Hurtubia et al, 2014 ; Shen, 2009 ; Bhat, 1997 ) vehicle ownership ( Ferguson et al, 2018 ), and in the field of environmental economics ( Araghi et al, 2016 ; Beharry-Borg and Scarpa, 2010 ).…”