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Towards Personalising the Use of Biologics in Rheumatoid Arthritis: A Discrete Choice Experiment

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  • Caroline M Vass

    (The University of Manchester)

  • Anne Barton

    (The University of Manchester
    Manchester University Foundation Trust)

  • Katherine Payne

    (The University of Manchester)

Abstract

Introduction There have been promising developments in technologies and associated algorithm-based prescribing (‘stratified approach’) to target biologics to sub-groups of people with rheumatoid arthritis (RA). The acceptability of using an algorithm-guided approach in practice is likely to depend on various factors. Objective This study quantified preferences for an algorithm-guided approach to prescribing biologics (termed ‘biologic calculator’). Methods An online discrete choice experiment (DCE) was designed to elicit preferences from patients and the public for using a ‘biologic calculator’ compared with conventional prescribing. Treatment approaches were described by five attributes: delay to starting treatment; positive and negative predictive value (PPV/NPV); risk of infection; and cost saving to the UK national health service. Each survey contained six choice sets asking respondents to select their preferred option from two hypothetical biologic calculators or conventional prescribing. Background questions included sociodemographics, health status and healthcare experiences. DCE data were analysed using mixed logit models. Results Completed choice data were collected from 292 respondents (151 patients with RA and 142 members of the public). PPV, NPV and risk of infection were the most highly valued attributes to respondents deciding between prescribing strategies. Conclusion Respondents were generally receptive to personalised medicine in RA, but researchers developing personalised approaches should pay close attention to generating evidence on both the PPV and the NPV of their technologies.

Suggested Citation

  • Caroline M Vass & Anne Barton & Katherine Payne, 2022. "Towards Personalising the Use of Biologics in Rheumatoid Arthritis: A Discrete Choice Experiment," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 15(1), pages 109-119, January.
  • Handle: RePEc:spr:patien:v:15:y:2022:i:1:d:10.1007_s40271-021-00533-z
    DOI: 10.1007/s40271-021-00533-z
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    References listed on IDEAS

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    1. Esther Bekker-Grob & Bas Donkers & Marcel Jonker & Elly Stolk, 2015. "Sample Size Requirements for Discrete-Choice Experiments in Healthcare: a Practical Guide," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(5), pages 373-384, October.
    2. Bruno Fautrel & Ann E. Clarke & Francis Guillemin & Viviane Adam & Yvan St-Pierre & Tina Panaritis & Paul R. Fortin & Henri A. Menard & Cam Donaldson & John R. Penrod, 2007. "Costs of Rheumatoid Arthritis: New Estimates from the Human Capital Method and Comparison to the Willingness-to-Pay Method," Medical Decision Making, , vol. 27(2), pages 138-150, March.
    3. Stuart J. Wright & Caroline M. Vass & Gene Sim & Michael Burton & Denzil G. Fiebig & Katherine Payne, 2018. "Accounting for Scale Heterogeneity in Healthcare-Related Discrete Choice Experiments when Comparing Stated Preferences: A Systematic Review," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 11(5), pages 475-488, October.
    4. Aki Tsuchiya & Verity Watson, 2017. "Re‐Thinking ‘The Different Perspectives That can be Used When Eliciting Preferences in Health’," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 103-107, December.
    5. Bloom, Gerald & Standing, Hilary & Lloyd, Robert, 2008. "Markets, information asymmetry and health care: Towards new social contracts," Social Science & Medicine, Elsevier, vol. 66(10), pages 2076-2087, May.
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