Patient Preferences for Injectable Treatments for Multiple Sclerosis in the United States: A Discrete-Choice Experiment

Poulos, Christine; Kinter, Elizabeth; Yang, Jui; Bridges, John F.P.; Posner, Joshua; Reder, Anthony T.

doi:10.1007/s40271-015-0136-x

Cited by 35 publications

(39 citation statements)

References 42 publications

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“…These results suggest, that patients do differentiate between injectable treatments based on injection frequency. This is consistent with data presented in previous studies [Poulos et al 2015;Shingler et al 2013;Utz et al 2014;Wicks et al 2015]. The change in injection time was not shown as being important to patients compared with the other attributes studied.…”

Section: Discussionsupporting

confidence: 92%

“…As expected, patients preferred an improvement in outcomes for each attribute, which is consistent with the results of previous DCE studies [Johnson et al 2009;Shingler et al 2013;Poulos et al 2015;Utz et al 2014;Wicks et al 2015;Wilson et al 2014Wilson et al , 2015.…”

Section: Discussionsupporting

confidence: 91%

“…The study investigators employed an online DCE, similar to the design previously used to examine US patient preference for injectable treatments for MS [Poulos et al 2015]. The survey design, administration, and analysis followed the guidelines for DCE applications in healthcare [Bridges et al 2011].…”

Section: Methodsmentioning

confidence: 99%

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A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Poulos

Kinter

Yang

et al. 2016

Ther Adv Neurol Disord

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Objectives: The aim of this study was to assess the relative importance of features of a hypothetical injectable disease-modifying treatment for patients with multiple sclerosis using a discrete-choice experiment. Methods: German residents at least 18 years of age with a self-reported physician diagnosis of multiple sclerosis completed a 25-30 minute online discrete-choice experiment. Patients were asked to choose one of two hypothetical injectable treatments for multiple sclerosis, defined by different levels of six attributes (disability progression, the number of relapses in the next 4 years, injection time, frequency of injections, presence of flu-like symptoms, and presence of injection-site reactions). The data were analyzed using a random-parameters logit model. Results: Of 202 adults who completed the survey, results from 189 were used in the analysis. Approximately 50% of all patients reported a diagnosis of relapsing-remitting multiple sclerosis, and 31% reported secondary progressive multiple sclerosis. Approximately 71% of patients had current or prior experience with injectable multiple sclerosis medication. Approximately 53% had experienced flu-like symptoms caused by their medication, and 47% had experienced mild injection-site reactions. At least one significant difference was seen between levels in all attributes, except injection time. The greatest change in relative importance between levels of an attribute was years until symptoms get worse from 1 to 4 years. The magnitude of this difference was about twice that of relapses in the next 4 years, frequency of injections, and flu-like symptoms. Conclusions: Most attributes examined in this experiment had an influence on patient preference. Patients placed a significant value on improvements in the frequency of dosing and disability progression. Results suggest that changes in injection frequency can be as important as changes in efficacy and safety attributes. Understanding which attributes of injectable therapies influence patient preference could potentially improve outcomes and adherence in patients with multiple sclerosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

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A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Poulos

Kinter

Yang

et al. 2016

Ther Adv Neurol Disord

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“…[3][4][5]9,10 The results of this study suggest that patients with different treatment histories and different levels of disability may place more emphasis on different features of medicines. In addition, given the problems with adherence, new DMTs with alternative routes of administration and dosing frequencies-such as less frequent IV infusions-may provide an alternative that will improve adherence.…”

Section: Figure 4 Self-injectable Treatment Subgroups: Relative Impomentioning

confidence: 82%

Preferences for Multiple Sclerosis Treatments

Mansfield¹,

Thomas²,

Gebben³

et al. 2017

International Journal of MS Care

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“…In all the GLP-1RA studies, a once-weekly dosing regimen was consistently preferred over a once-daily dosing regimen [30, 31, 36, 37, 46, 47]. Interestingly, DCE studies in patients with another chronic disease (multiple sclerosis; MS) also found that the frequency of injections was an important driver of preference for injectable MS treatments [48, 49]. …”

Section: Discussionmentioning

confidence: 99%

Glucagon-Like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Experienced Patients with Type 2 Diabetes Mellitus: A Preference Study in Germany and the United Kingdom

Qin

Chen

Flood³

et al. 2017

Diabetes Ther

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IntroductionThis study assessed the relative importance of treatment-related attributes in influencing patient preferences for glucagon-like peptide-1 receptor agonists (GLP-1RAs) among injection-experienced type 2 diabetes mellitus (T2DM) patients in Germany and the United Kingdom.MethodsT2DM patients experienced with injecting once-weekly (QW) exenatide or once-daily (QD) liraglutide completed an online discrete-choice experiment (DCE) survey. Patients chose between hypothetical blinded treatment profiles reflecting attributes of GLP-1RAs. The DCE survey included eight attributes: efficacy, side effects, device size, needle size, titration, injection preparation, long-term efficacy/safety, and dosing frequency. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a conditional logit model indicating the likelihood of choosing a treatment with a given attribute level versus a reference attribute level.Results510 GLP-1RA injection-experienced patients completed the survey; 45.3% respondents were being treated with exenatide QW and 54.7% respondents were being treated with liraglutide QD. In terms of GLP-1RA attributes, patients indicated a preference for a treatment with greater efficacy (i.e., a 1.5-point improvement in HbA1c) (OR 2.58; 95% CI 2.37, 2.80; p < 0.001), fewer side effects (OR 2.67; 95% CI 2.52, 2.82; p < 0.001), once-weekly rather than once-daily administration (OR 2.26; 95% CI 2.13, 2.39; p < 0.001), and the preparation required for a multi-use pen (OR 1.71; 95% CI 1.55, 1.88; p < 0.001). Needle size, device size, and titration were not significant drivers of patient preference.ConclusionsAmong GLP-1RA injection-experienced patients, key drivers of treatment preference for a hypothetical GLP-RA profile were side effects, efficacy, dosing frequency, and required preparation. Understanding patient preferences is important for optimizing treatment decision-making and improving treatment adherence. Funding: AstraZeneca.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0237-8) contains supplementary material, which is available to authorized users.

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Patient Preferences for Injectable Treatments for Multiple Sclerosis in the United States: A Discrete-Choice Experiment

Cited by 35 publications

References 42 publications

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Preferences for Multiple Sclerosis Treatments

Glucagon-Like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Experienced Patients with Type 2 Diabetes Mellitus: A Preference Study in Germany and the United Kingdom

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