Deutsche Initiative für Netzwerkinformation

OBJECTIVE: To assess the importance of disease modifying treatment (DMT) characteristics for multiple sclerosis (MS) patient preferences. BACKGROUND: There is a variety of DMTs available for MS. These are associated with different characteristics in key attributes such as side effects, mode of administration etc. A quantitative assessment of the relative importance of different DMT features from a patient’s perspective is needed. DESIGN/METHODS: In a discrete choice experiment (DCE), MS patients from 38 neurological practices in Germany (n=1,628) were asked to choose the most and the least preferred drug (best-worst-scaling) among hypothetical multi-attribute alternatives with varying levels of the following key attributes: mode of administration, local and systemic side effects, frequency of administration, and required monitoring of the patient. This design simulates a real choice situation between different treatment alternatives. RESULTS: On average, patients (74.6% female) were 42.4 years of age with 9.9 years of disease duration, and 87.8% reporting experience with injectable DMTs. 1,311 patients (80.5% of the sample) completed the DCE; drop-outs (n=317) showed longer disease duration (11.1 vs. 9.6 years), a lower health status according to EQ-5D, and were more likely to be without current DMT (26.1 vs. 16.2%) than patients completing the DCE. Count analysis including subjects completing the DCE yielded mode of administration to be the most important attribute guiding patients' preferences, with 'oral application' being most desired (selected as best option in 63% of the cases). The second most relevant attribute was frequency of administration, with 'administration once weekly' being the most preferred attribute level (in 47% of the cases). CONCLUSIONS: Our data indicate that for MS patients, the most important attributes of DMTs are route of administration (oral being the number one choice by majority) and frequency of administration (with intake once a week being the most preferred). This could be due to these aspects meeting the patients' need for low treatment burden in daily life. Study Supported by: Biogen Idec GmbH.