Aleksandra Torbica1, Giovanni Fattore, Fabio Ayala. 1. Department of Policy Analysis and Public Management, Università Commerciale Luigi Bocconi, Via Roentgen 1, 20136, Milan, Italy.
Abstract
OBJECTIVE: To assess patient preferences for psoriasis treatment features and to investigate the heterogeneity of preferences among patients with different socio-demographic and disease-related characteristics. METHODOLOGY: A discrete choice experiment was conducted on adult patients with moderate to severe plaque-type psoriasis during a routine visit to their physician at 15 centres in Italy. We investigated the preferences of patients with respect to five treatment attributes: (1) mode and frequency of administration; (2) time to improvement; (3) time free of symptoms; (4) unintended life expectancy reduction resulting from treatment; and (5) monthly treatment cost. The heterogeneity of preferences was investigated in a mixed logit model with normally distributed random coefficients. RESULTS: Overall, patients preferred the subcutaneous or intravenous route of administration (versus oral administration) and treatments that took less time to show improvement, ensured a longer time free of symptoms, involved a lesser reduction in life expectancy and had lower costs. There was significant preference heterogeneity for all attributes. The cost attribute was found to be significantly more important to females and to older patients (above 60 years of age). Older patients placed significantly greater emphasis on reduced life expectancy, whereas the time free of symptoms was significantly less important to them than to patients under 60 years of age. Patients with higher scores on the Dermatology Life Quality Index (DLQI) placed higher value on the time free of symptoms than those with lower DLQI scores. For the overall sample, the marginal willingness to pay (WTP) for a month's reduction in the time to improvement was <euro>32.4, whereas the WTP for one additional month without symptoms was significantly higher (<euro>68.2). CONCLUSION: Patient-centred policies should consider the heterogeneity of patients' expectations to identify individualized treatments that would aid in optimizing patient satisfaction and wellbeing, as well as overall treatment effectiveness.
OBJECTIVE: To assess patient preferences for psoriasis treatment features and to investigate the heterogeneity of preferences among patients with different socio-demographic and disease-related characteristics. METHODOLOGY: A discrete choice experiment was conducted on adult patients with moderate to severe plaque-type psoriasis during a routine visit to their physician at 15 centres in Italy. We investigated the preferences of patients with respect to five treatment attributes: (1) mode and frequency of administration; (2) time to improvement; (3) time free of symptoms; (4) unintended life expectancy reduction resulting from treatment; and (5) monthly treatment cost. The heterogeneity of preferences was investigated in a mixed logit model with normally distributed random coefficients. RESULTS: Overall, patients preferred the subcutaneous or intravenous route of administration (versus oral administration) and treatments that took less time to show improvement, ensured a longer time free of symptoms, involved a lesser reduction in life expectancy and had lower costs. There was significant preference heterogeneity for all attributes. The cost attribute was found to be significantly more important to females and to older patients (above 60 years of age). Older patients placed significantly greater emphasis on reduced life expectancy, whereas the time free of symptoms was significantly less important to them than to patients under 60 years of age. Patients with higher scores on the Dermatology Life Quality Index (DLQI) placed higher value on the time free of symptoms than those with lower DLQI scores. For the overall sample, the marginal willingness to pay (WTP) for a month's reduction in the time to improvement was <euro>32.4, whereas the WTP for one additional month without symptoms was significantly higher (<euro>68.2). CONCLUSION:Patient-centred policies should consider the heterogeneity of patients' expectations to identify individualized treatments that would aid in optimizing patient satisfaction and wellbeing, as well as overall treatment effectiveness.
Authors: Madeleine T King; Jane Hall; Emily Lancsar; Denzil Fiebig; Ishrat Hossain; Jordan Louviere; Helen K Reddel; Christine R Jenkins Journal: Health Econ Date: 2007-07 Impact factor: 3.046
Authors: Nasir Umar; David Litaker; Marthe-Lisa Schaarschmidt; Wiebke K Peitsch; Astrid Schmieder; Darcey D Terris Journal: BMC Health Serv Res Date: 2012-01-03 Impact factor: 2.655
Authors: Craig Leonardi; Kristian Reich; Peter Foley; Hideshi Torii; Sascha Gerdes; Lyn Guenther; Melinda Gooderham; Laura K Ferris; Christopher E M Griffiths; Hany ElMaraghy; Heidi Crane; Himanshu Patel; Russel Burge; Gaia Gallo; David Shrom; Ann Leung; Chen-Yen Lin; Kim Papp Journal: Dermatol Ther (Heidelb) Date: 2020-03-21