Balancing the Benefits and Risks of Drug Treatment

Abstract

To examine the extent to which the attributes of a treatment affect patients' choice of treatment for psoriasis and the magnitude and nature of trade-offs between risks and benefits of treatment.Design: A questionnaire, including a stated-preference, discrete choice experiment, was used to elicit patients' preferences for the treatment of psoriasis. Setting: Dermatology clinics in England.Patients: A total of 126 patients with psoriasis.Main Outcome Measures: Preferences of patients for, and trade-offs between, the 6 attributes of time to moderate (50%) improvement, relapse, and risks of experiencing skin irritation, high blood pressure, liver damage, and skin cancer. Results: The mean age of respondents was 47.6 years, and the mean duration of psoriasis was 23 years. All 6 attributes were important factors affecting choice of treatment. The results indicated that patients with psoriasis prioritized low risk of skin cancer (␤=−0.054; PϽ.01) and liver damage (␤ = −0.054; P Ͻ .01) and preferred treatment that resulted in a shorter time to achieve a moderate improvement (␤=−0.034; PϽ.01) over a longer time to relapse (␤=0.028; PϽ.01). Patients were most willing to wait longer for a treatment to work if the likelihood of skin cancer or liver damage was reduced.Conclusions: This study shows that treatment attributes influence patients with psoriasis in their choice of treatment. The results of the discrete choice experiment presented herein indicate that most respondents would be willing to trade between different aspects of treatment to achieve improvements in their psoriasis and minimize the risks of adverse events.

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

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Patient-centred Preferences for Biologic Therapies in Moderate to Severe Psoriasis in Vietnam: A Discrete Choice Experiment

“…The patients in this study preferred biologics with a severe infection rate of 2% to those with higher rates, especially female patients, individuals over 60 years of age, and those currently receiving non-biologic therapies. This mirrors findings from previous studies ( 25 , 26 ), though some studies have reported that patients were willing to accept higher risks for greater efficacy ( 21 – 23 ). These differences may reflect varying perceptions of safety and risk tolerance across populations.…”

It is not always about gains: utilities and disutilities associated with treatment features in patients with moderate-to-severe psoriasis

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