Teresa L Kauf1, Jui-Chen Yang2, Alexa B Kimball3, Murali Sundaram4, Yanjun Bao4, Martin Okun4, Parvez Mulani4, A Brett Hauber5, F Reed Johnson6. 1. a Cubist Pharmaceuticals , Lexington , MA , USA . 2. b Pacific Economics Research, LLC , Bellevue , WA , USA . 3. c Massachusetts General Hospital , Boston , MA , USA . 4. d AbbVie Inc . , North Chicago , IL , USA . 5. e RTI Health Solutions, Research Triangle Park , NC , USA , and. 6. f Center for Clinical and Genetic Economics, Duke Clinical Research Institute , Durham , NC , USA.
Abstract
BACKGROUND: Previous studies suggest that efficacy is more important than side-effect risks to psoriasis patients. However, those studies did not consider potentially fatal risks of biologic treatments. OBJECTIVE: To quantify the risks patients are willing to accept for improvements in psoriasis symptoms. METHODS: Adults with a self-reported physician diagnosis of psoriasis were recruited through the National Psoriasis Foundation. Using a discrete-choice experiment, patients completed a series of nine choice questions, each including a pair of hypothetical treatments. Treatments were defined by severity of plaques, body surface area (BSA), and 10-year risks of tuberculosis, serious infection and lymphoma. RESULTS: For complete clearance of 25% BSA with mild plaques, respondents (n = 1608) were willing to accept a 20% (95% confidence interval: 9-26%) risk of serious infection, 10% (5-15%) risk of tuberculosis and 2% (1-3%) risk of lymphoma. For complete clearance of 25% BSA with severe plaques, respondents were willing to accept a 54% (48-62%) risk of serious infection, 36% (28-49%) risk of tuberculosis and 8% (7-9%) risk of lymphoma. LIMITATIONS: Respondents were asked to evaluate hypothetical scenarios. Actual treatment choices may differ. CONCLUSION: Respondents were willing to accept risks above likely clinical exposures for improvements in psoriasis symptoms. Individual risk tolerances may vary.
BACKGROUND: Previous studies suggest that efficacy is more important than side-effect risks to psoriasispatients. However, those studies did not consider potentially fatal risks of biologic treatments. OBJECTIVE: To quantify the risks patients are willing to accept for improvements in psoriasis symptoms. METHODS: Adults with a self-reported physician diagnosis of psoriasis were recruited through the National Psoriasis Foundation. Using a discrete-choice experiment, patients completed a series of nine choice questions, each including a pair of hypothetical treatments. Treatments were defined by severity of plaques, body surface area (BSA), and 10-year risks of tuberculosis, serious infection and lymphoma. RESULTS: For complete clearance of 25% BSA with mild plaques, respondents (n = 1608) were willing to accept a 20% (95% confidence interval: 9-26%) risk of serious infection, 10% (5-15%) risk of tuberculosis and 2% (1-3%) risk of lymphoma. For complete clearance of 25% BSA with severe plaques, respondents were willing to accept a 54% (48-62%) risk of serious infection, 36% (28-49%) risk of tuberculosis and 8% (7-9%) risk of lymphoma. LIMITATIONS: Respondents were asked to evaluate hypothetical scenarios. Actual treatment choices may differ. CONCLUSION: Respondents were willing to accept risks above likely clinical exposures for improvements in psoriasis symptoms. Individual risk tolerances may vary.