INTRODUCTION: This study quantified German physician preferences for attributes of disease-modifying treatments for multiple sclerosis (MS) and examines subgroups with distinct preferences.
METHODS: Physicians treating MS completed an online discrete-choice-experiment survey with one series of treatment-choice questions for each of two hypothetical patient profiles: more advanced and less advanced. The order in which the hypothetical patient profiles were shown was randomised. Each hypothetical treatment had seven attributes with varying levels: years until disability progression; number of relapses in the next 10 years; mode of administration; dosing frequency; and risks of mild, moderate, and severe adverse events (AEs). Latent class analysis was used to estimate preferences for subgroups. Logit regression analysis examined physician characteristics associated with likely subgroup membership.
RESULTS: Three sub groups with distinct preferences were identified among 308 respondents (n = 155 neurologists; n = 153 internists). Subgroup 1 members (45% of sample) placed greatest importance (conditional on study attribute levels) on delaying disability progression, followed by minimising risks of severe AEs. Members of this subgroup were more likely to have considered the more advanced hypothetical patient profile first. They were more likely to be in their 40s than their 50s and less likely to be concerned about immunosuppressive effects of treatment. Subgroup 2 members (33% of sample) placed the greatest importance on minimising risks of severe AEs, followed by delaying progression. Members of this subgroup were more likely to have considered the less advanced hypothetical patient profile first and more likely to believe that disease progression would affect other MS symptoms in additional to ambulation. Subgroup 3 members (22% of sample) placed greatest importance on minimising risks of mild, moderate, and severe AEs. Members of this subgroup were more likely to treat more than 10 patients with MS per week, more likely to be concerned about immunosuppression, more likely to be in their 50s than their 40s, and more likely to believe that the hypothetical treatments would only affect progression of ambulation symptoms and no other symptoms.
CONCLUSION: These findings suggest that physicians' age and experience may determine their treatment preferences and recommendations. These data may shed light on treatment patterns and MS treatment outcomes.
