Mühlbacher Axel, Bethge Susanne
Health Economics and Healthcare Management, Hochschule Neubrandenburg, Neubrandenburg, Germany.
Health Economics and Healthcare Management, Hochschule Neubrandenburg, Neubrandenburg, Germany.
Value Health. 2016 Sep-Oct;19(6):776-787. doi: 10.1016/j.jval.2016.04.007.
There has been tremendous progress regarding treatment options for hepatitis C virus (HCV) infection. Several interferon-free regimens are awaiting regulatory approval. These innovations promise substantial reductions in the burden of disease and side effects as well as a decrease in treatment duration.
The aim of this quantitaitive study was to elicit patient preferences for attributes of innovative antiviral therapies for hepatitis C.
A systematic literature search and 14 semi-structured interviews were performed, resulting in eight patient-relevant characteristics. For the discrete choice experiment, an experimental design (3×3 + 5×6) was generated using Ngene software. The survey was conducted in August 2014 through computer-assisted personal interviews. The data were effects-coded in a random parameter logit estimation.
Participants were patients with HCV (N = 561; 58.1% men) in different treatment states. The analysis revealed a predominance of the attribute "reaching sustained virological response." When considering confidence intervals, the results showed three different preference ranks. At first place was "sustained virological response" (level difference [LD] 3.98), second was "anemia" (LD 1.10), followed by "number of interferon injections" (LD 0.92), "rash" (LD 0.82), "nausea and/or diarrhea" (LD 0.79), and "duration of antiviral therapy" (LD 0.78). The last position was occupied by both "tiredness/fatigue" (LD 0.31) and "headache" (LD 0.34).
From the patients' point of view, sustained virological response is the most essential criterion for choosing an HCV therapy. It was ranked at the highest, dominating all side effects and modes of administration. Furthermore, this study proved that patients consider both the probability of occurrence and the severity of treatment-induced side effects. Results clearly point to valuation of probabilities that is separate from that of severity.
丙型肝炎病毒（HCV）感染的治疗选择已取得巨大进展。几种不含干扰素的治疗方案正在等待监管批准。这些创新有望大幅减轻疾病负担和副作用，并缩短治疗时间。
本定量研究的目的是了解患者对丙型肝炎创新抗病毒疗法属性的偏好。
进行了系统的文献检索和14次半结构化访谈，得出8个与患者相关的特征。对于离散选择实验，使用Ngene软件生成了一个实验设计（3×3 + 5×6）。该调查于2014年8月通过计算机辅助个人访谈进行。数据在随机参数logit估计中进行效应编码。
参与者为处于不同治疗状态的HCV患者（N = 561；58.1%为男性）。分析显示，“达到持续病毒学应答”这一属性占主导地位。考虑置信区间时，结果显示出三种不同的偏好等级。排在首位的是“持续病毒学应答”（水平差异[LD] 3.98），其次是“贫血”（LD 1.10），接着是“干扰素注射次数”（LD 0.92）、“皮疹”（LD 0.82）、“恶心和/或腹泻”（LD 0.79）以及“抗病毒治疗持续时间”（LD 0.78）。最后一位是“疲倦/乏力”（LD 0.31）和“头痛”（LD 0.34）。
从患者的角度来看，持续病毒学应答是选择HCV治疗方法的最关键标准。它排名最高，超过所有副作用和给药方式。此外，本研究证明患者会同时考虑治疗引起的副作用的发生概率和严重程度。结果清楚地表明，对概率的评估与对严重程度的评估是分开的。
