Balancing the benefits and risks of drug treatment: a stated-preference, discrete choice experiment with patients with psoriasis.

OBJECTIVE

To examine the extent to which the attributes of a treatment affect patients' choice of treatment for psoriasis and the magnitude and nature of trade-offs between risks and benefits of treatment.

DESIGN

A questionnaire, including a stated-preference, discrete choice experiment, was used to elicit patients' preferences for the treatment of psoriasis.

SETTING

Dermatology clinics in England.

PATIENTS

A total of 126 patients with psoriasis.

MAIN OUTCOME MEASURES

Preferences of patients for, and trade-offs between, the 6 attributes of time to moderate (50%) improvement, relapse, and risks of experiencing skin irritation, high blood pressure, liver damage, and skin cancer.

RESULTS

The mean age of respondents was 47.6 years, and the mean duration of psoriasis was 23 years. All 6 attributes were important factors affecting choice of treatment. The results indicated that patients with psoriasis prioritized low risk of skin cancer (beta = -0.054; P < .01) and liver damage (beta = -0.054; P < .01) and preferred treatment that resulted in a shorter time to achieve a moderate improvement (beta = -0.034; P < .01) over a longer time to relapse (beta = 0.028; P < .01). Patients were most willing to wait longer for a treatment to work if the likelihood of skin cancer or liver damage was reduced.

CONCLUSIONS

This study shows that treatment attributes influence patients with psoriasis in their choice of treatment. The results of the discrete choice experiment presented herein indicate that most respondents would be willing to trade between different aspects of treatment to achieve improvements in their psoriasis and minimize the risks of adverse events.