OBJECTIVES: To quantify German multiple sclerosis (MS) patient preferences for attributes of disease-modifying treatments and examine subgroups with distinct preferences.
METHODS: Respondents with self-reported MS completed an online discrete-choice-experiment survey with a series of treatment-choice questions. 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 was used to identify and describe likely members of the preference subgroups. Likely uptake of treatment profiles similar to available products was calculated by subgroup.
RESULTS: There were two subgroups with distinct preferences amongst the 301 respondents. Subgroup 1 (43% of sample) was risk-focused and placed greatest importance (conditional on levels in the study) on minimizing risks of severe, moderate, and mild AEs, followed by avoiding relapses and delaying progression. Dosing frequency and mode were least important to this subgroup. Subgroup 2 (57% of sample) was efficacy- and severe AE-focused and placed the greatest importance on delaying progression and minimizing risks of severe AEs. The next most important attributes were risks of mild AEs and mode of administration. Dosing frequency and avoiding relapses were least important to this subgroup. Subgroups placed different relative importances on different treatment attributes. Decreasing the severe AE risk from 7% to 0% was 3.1 times as important as increasing the delay in progression from 2 years to 8 years for the risk-focused group. In contrast, for the efficacy-focused group, this delay in progression was 1.4 times more important than this risk reduction.
CONCLUSIONS: Understanding the preferences of different patients will enable shared-decision making between physicians and patients, which may improve treatment satisfaction and adherence.
