Investigating Patients’ Preferences to Inform Drug Development Decisions: Novel Insights From a Discrete Choice Experiment in Migraine

Abstract

Background: Chronic conditions have important long-term consequences for patients’ personal and social lives and require patient commitment to their management. In this context, the assessment of patients’ preferences for treatment characteristics would increase the current evidence on the impact of diseases to support decision-making processes in the field of public policies and research and development in pharmaceutical industries.The present study used cases of chronic migraine to assess patients’ preferences, including the analysis of gender differences, for the characteristics of an ideal migraine treatment. Methods: A discrete choice experiment was performed with 466 adults with migraine in Italy who experienced at least 4 attacks per month. We investigated the preferences of patients with respect to five treatment attributes that were identified from a systematic literature review and two focus group elicitations. The heterogeneity of preferences was investigated in a mixed logit model with normally distributed random coefficients.Results: Overall, the respondents considered the presence of adverse events, duration of the treatment effect, reduction of symptom intensity, speed of the effect and the cost born by the patient as the most relevant treatment features. As expected, the patients preferred treatments with lower levels of adverse events and costs and treatments with greater speed, duration of treatment effect and effectiveness in reducing symptom intensity. There was significant preference heterogeneity only for the presence of adverse events. Compared to men, women had significantly higher preferences for quicker treatment effect and limited adverse events and reported higher preferences for costly treatments.Conclusions: The results of our survey help address research and development strategies in the pharmaceutical industry and public policy regarding treatments that are clinically effective and responsive to the needs expressed by patients.