OBJECTIVE: To estimate and compare treatment preferences among patients with relapsing-remitting multiple sclerosis (RRMS).
BACKGROUND: There is a need to understand the trade-offs patients make in treatment decision-making as more therapies become available for the treatment of RRMS.
METHODS: US patients who reported receiving a physician diagnosis of RRMS completed a web-based, discrete choice experiment survey that presented 10 choices between pairs of hypothetical MS treatments. The treatment attributes were informed by the literature and clinician input and tested in patient interviews. Attributes included: chance of MS progression; years between relapses; risk of serious infection; route of delivery and frequency of administration; and chance of flu-like and gastrointestinal symptoms. The treatment profiles in the questions were created using an experimental design.
RESULTS: A total of 301 patients completed the survey: 81% were female; mean age was 54 years; 56% rated their disability level as "normal" or "mild"; 79% reported receiving treatment; and 42% used an injectable MS treatment. Overall, respondents with normal or mild disability had significantly different preferences than respondents with moderate or worse disability (p less than 0.05). Patients with worse disability placed the greatest weight on reducing the chance of MS progression and risk of serious infection. Patients with normal or mild disability placed the greatest weight on avoiding injections with flu-like symptoms, followed by the chance of progression. Overall, patients receiving an injectable treatment had significantly different preferences than those who did not (p less than 0.05). Injectable users placed the most weight on the chance of progression and risk of serious infection and preferred intravenous therapy administered twice a year versus every month.
CONCLUSIONS: The preferences of RRMS patients varied depending on their current treatment and disability level. Considering patient preferences for efficacy, side effects and dosing may lead to higher treatment satisfaction and adherence.
