Patient preferences for biologic agents in rheumatoid arthritis: a discrete-choice experiment

AUGUSTOVSKI, F.; BERATARRECHEA, A.; IRAZOLA, V.; RUBINSTEIN, F.; TESOLIN, P.; GONZALEZ, J.; LENCINA, V.; SCOLNIK, M.; WAIMANN, C.; NAVARTA, D.; CITERA, G.; SORIANO, E. R.

Value Health

Value Health

Año: 2013 p. 1 - 30

1524-4733

OBJECTIVES: To assess patients´ preferences for rheumatoid-arthritis treatments with biologic agents using a discrete-choice experiment. METHODS: A discrete-choice experiment was conducted with adult rheumatoid-arthritis patients who had never been treated with biological agents from two university hospitals-public and private-in Buenos Aires, Argentina. We evaluated preferences for seven treatment attributes (with two to three levels each): effectiveness, mode of administration, frequency of administration, local and systemic adverse events, severe infections, and out-of-pocket costs.A probit regression model was used to analyze the relative importance of rheumatoid-arthritis treatment attributes. We estimated attributes´ relative importance and their 95% confidence intervals. RESULTS: Survey responses from 240 patients with rheumatoid arthritis receiving conventional disease-modifying antirheumatic drugs were included in the study. All tested biological agents´ attributes significantly affected the choice of treatment. Attributes´ relative importance in decreasing order was the following (mean, confidence interval 95%): cost, 0.81 (0.69-0.92); systemic adverse events, 0.66 (0.57-0.76); frequency of administration, 0.61 (0.52-0.71); efficacy, 0.42 (0.32-0.51); route of administration, 0.41 (0.30-0.52); local adverse events, 0.40 (0.31-0.49); and serious infections, 0.29 (0.22-0.37). CONCLUSIONS: Different treatment attributes had a significant and different influence in rheumatoid-arthritis patients´ choice of biological agents. This type of study can not only inform about patients´ preferences but also about the trade-offs among different possible treatments or process-related attributes.