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Summarizing Patient Preferences for the Competitive Landscape of Multiple Sclerosis Treatment Options

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  • Marcel F. Jonker

    (Duke Clinical Research Institute, Duke University, Durham, NC, USA
    Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, the Netherlands
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands)

  • Bas Donkers

    (Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, the Netherlands
    Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands)

  • Lucas M.A. Goossens

    (Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, the Netherlands
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands)

  • Renske J. Hoefman

    (Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, the Netherlands
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands)

  • Lea J. Jabbarian

    (Erasmus MC–Erasmus University Medical Centre, Rotterdam, The Netherlands)

  • Esther W. de Bekker-Grob

    (Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, the Netherlands
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands)

  • Matthijs M. Versteegh

    (Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
    Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands)

  • Gerard Harty

    (EMD Serono Inc., Billerica, MA, USA)

  • Schiffon L. Wong

    (EMD Serono Inc., Billerica, MA, USA)

Abstract

Objective. Quantitatively summarize patient preferences for European licensed relapsing-remitting multiple sclerosis (RRMS) disease-modifying treatment (DMT) options. Methods. To identify and summarize the most important RRMS DMT characteristics, a literature review, exploratory physician interviews, patient focus groups, and confirmatory physician interviews were conducted in Germany, the United Kingdom, and the Netherlands. A discrete choice experiment (DCE) was developed and executed to measure patient preferences for the most important DMT characteristics. The resulting DCE data ( n =799 and n =363 respondents in the United Kingdom and Germany, respectively) were analyzed using Bayesian mixed logit models. The estimated individual-level patient preferences were subsequently summarized using 3 additional analyses: the quality of the choice data was assessed using individual-level R 2 estimates, individual-level preferences for the available DMTs were aggregated into DMT-specific preference shares, and a principal component analysis was performed to explain the patients’ choice process. Results. DMT usage differed between RRMS patients in Germany and the United Kingdom but aggregate patient preferences were similar. Across countries, 42% of all patients preferred oral medications, 38% infusions, 16% injections, and 4% no DMT. The most often preferred DMT was natalizumab (26%) and oral DMT cladribine tablets (22%). The least often preferred were mitoxantrone and the beta-interferon injections (1%–3%). Patient preferences were strongly correlated with patients’ MS disease duration and DMT experience, and differences in patient preferences could be summarized using 8 principle components that together explain 99% of the variation in patients’ DMT preferences. Conclusion. This study summarizes patient preferences for the included DMTs, facilitates shared decision making along the dimensions that are relevant to RRMS patients, and introduces methods in the medical DCE literature that are ideally suited to summarize the impact of DMT introductions in preexisting treatment landscapes.

Suggested Citation

  • Marcel F. Jonker & Bas Donkers & Lucas M.A. Goossens & Renske J. Hoefman & Lea J. Jabbarian & Esther W. de Bekker-Grob & Matthijs M. Versteegh & Gerard Harty & Schiffon L. Wong, 2020. "Summarizing Patient Preferences for the Competitive Landscape of Multiple Sclerosis Treatment Options," Medical Decision Making, , vol. 40(2), pages 198-211, February.
    • Handle: RePEc:sae:medema:v:40:y:2020:i:2:p:198-211
    DOI: 10.1177/0272989X19897944
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    References listed on IDEAS

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    1. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555, January.
    2. Daniel McFadden, 1977. "Quantitative Methods for Analyzing Travel Behaviour of Individuals: Some Recent Developments," Cowles Foundation Discussion Papers 474, Cowles Foundation for Research in Economics, Yale University.
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