OBJECTIVES: To estimate patient preferences for relapsing-remitting multiple sclerosis (RRMS) treatments
METHODS: Patients in the United States who reported receiving a diagnosis of MS from their physician completed a Web-based discrete-choice experiment (DCE) survey that included questions on treatment experience and adherence. The survey presented 10 DCE questions in which respondents were asked to choose between pairs of hypothetical MS treatment profiles. The profile attributes of the treatments were informed by a literature search and clinician input, and tested in patient interviews. Attributes included: change in MS progression and years between relapses; risk of serious infection; delivery method and frequency of administration; and chance of flu-like and gastrointestinal (GI) symptoms. The profiles in the DCE questions were based on an experimental design with known statistical properties. Random-parameters logit was used to estimate preferences.
RESULTS: The sample included 301 patients with RRMS: 81% were female; mean age was 54 years; 56% rated their disability level as “normal” or “mild”; and 79% reported currently receiving a prescription MS treatment. Nineteen percent reported stopping or skipping treatment doses due to flu-like symptoms and 9% due to GI symptoms. Respondents placed the greatest decision weight on reducing the chance of MS progression and risk of serious infection, as well as on the mode and frequency of administration. Followed by daily pills, an intravenous (IV) administration every 6 months was preferred over IV every month and injections 3 times per week (P < 0.05). Respondents reported being most likely to adhere to either daily pills or IV administration every 6 months (39% and 29% of patients, respectively).
CONCLUSIONS: Patients with RRMS reported that treatment preferences were influenced by efficacy, reduced side effects, and less burdensome modes of administration. Side effects and mode of administration also influenced reported likelihood of treatment adherence.
