OBJECTIVES: Biologic treatments for rheumatoid arthritis (RA) vary widely in both the time required to administer treatment and treatment frequency. The primary aim of this study is to quantify the tradeoffs RA patients are willing to make between treatment time and frequency.
METHODS: Patients with a self-reported physician diagnosis of moderate-to-severe RA completed a Web-enabled conjointanalysis survey. Severity of self-reported symptoms was determined by the Routine Assessment of Patient Index Data 3 (RAPID3) score. Patients were presented with a series of treatment-choice questions. Each hypothetical treatment included six attributes: response rate, mode of administration, treatment time, treatment frequency, and the risks of immediate, mild and serious treatment reactions. Preference weights were estimated using mixed-logit and were used to calculate the relative importance of treatment attributes and the marginal rate of substitution between treatment time and frequency (MRS).
RESULTS: A total of 901 patients completed the survey. The risk of serious treatment reaction was the most important attribute followed by the frequency of treatments and treatment response rate, which were equally important. The risk of a mild treatment reaction was the least important attribute. The MRS implies that if the duration of a 4-hour infusion administered 4 times per year were reduced to 2 hours: 1) the frequency would have to be 10.4 times per year to keep utility constant; 2) the frequency of a 4 hour infusion administered 4 times per year would have to be reduced to 1.6 times per year to generate an equivalent change in utility; and 3) there would be a 50% increase in predicted probability of choosing the treatment if all other attributes of this and other RA treatments were unchanged.
CONCLUSIONS: Convenience of RA treatment is important to RA patients. Treatment duration and frequency likely play an important role in patients’ choice of RA treatment.
