OBJECTIVES: To determine the attributes of biologic psoriasis treatment that drive US patients’ treatment choices.
METHODS: 300 respondents with moderate-to-severe psoriasis completed a discrete-choice-experiment survey with a series of choice questions among pairs of hypothetical treatments, each characterized by attributes with varying levels. Attributes were: chance of clear or almost clear skin after 1 year, number of treatments in the first year, risks of mild-to-moderate injection site reaction (ISR) and serious infection in the first year, and number of years studies have proven efficacy with no new side effects. Relative preference weights were estimated (using a mixed logit model) to calculate percentage point (PP) changes in predicted choice probability (PCP) given changes in one or more attributes. Positive and negative PP values indicate the attribute is a positive and negative driver of treatment choice, respectively.
RESULTS: An increased chance of clear skin from 50% or 60% to 80% (+37 to +28 PP), increased risk of ISR from 0 to 20% (-24 PP), number of treatments from 6 to 28 times (-21 PP), and 5 years of proven efficacy vs. 1 year (+18 PP) were most important drivers of treatment choice. Increased chance of clear skin was a bigger driver of treatment choice among biologic-experienced (n=150) respondents than biologic-naïve (n=150), while increases in number of treatments, the risks of ISR and of serious infection, and having 5 years of proven efficacy and safety were bigger drivers among the biologic-naïve respondents than biologic-experienced. The influence of combinations of attribute changes was also explored.
CONCLUSIONS: Clear skin is a key driver of patients’ psoriasis treatment choices. The risk of ISR, dosing frequency, and long-term evidence of efficacy and safety are also key drivers, especially among biologic-naïve patients. These results may empower physicians to align treatment with patients’ preferences through shared decision-making.
