RTI Health
Biogen.
Int J Technol Assess Health Care. 2018 Jan;34(4):425-433. doi: 10.1017/S0266462318000491.
Adherence to injectable disease-modifying treatments in patients with multiple sclerosis (MS) impacts outcomes and can be influenced by perceptions of treatment efficacy, side effects, injection frequency, and the duration of injection. This study aimed to quantify preferences for selected attributes of injectable treatments among individuals with MS in the United Kingdom and France.
Respondents with a self-reported diagnosis of MS completed an online discrete-choice-experiment survey, consisting of a series of treatment-choice questions. Each choice question presented two hypothetical treatments, each with six attributes (years until disability progression, relapses in the next 4 years, injection time, injection frequency, flu-like symptoms (FLS), and injection-site reactions), each with various levels. Mixed-logit regression analysis was used to estimate preference weights for attribute levels and to calculate the relative importance of changes in treatment attributes (vertical distance between preference weights). Minimum acceptable efficacy estimates indicate improvement in efficacy that respondents would require in exchange for worsening injection frequency and FLS.
In both countries, 100 respondents completed the survey. In the United Kingdom and France, respectively, improving the time until disability progression from 2 to 4 years, reducing injection frequency from "daily" to "every 2 weeks", and reducing FLS from 3 days after every injection to none had a relative importance of 2.9 and 2.6, 3.0 and 3.5, and 2.5 and 3.1. Given the ranges included in the study, changes in these attributes were more important than most changes in other attributes assessed.
Reductions in the injection frequency of MS treatments and FLS can be as important to patients as improvements in treatment efficacy.
多发性硬化症(MS)患者对注射用疾病修正治疗的依从性会影响治疗效果,而这种依从性可能受到对治疗效果、副作用、注射频率以及注射持续时间的看法的影响。本研究旨在量化英国和法国 MS 患者对注射治疗的特定属性的偏好。
自我报告患有 MS 的受访者完成了一项在线离散选择实验调查,该调查由一系列治疗选择问题组成。每个选择问题呈现两种假设的治疗方法,每种方法有六个属性(残疾进展的年限、未来 4 年内的复发次数、注射时间、注射频率、流感样症状(FLS)和注射部位反应),每个属性都有不同的水平。混合对数回归分析用于估计属性水平的偏好权重,并计算治疗属性变化的相对重要性(偏好权重之间的垂直距离)。最小可接受疗效估计表明,受访者需要在改善疗效方面取得多大的进步,才能换取注射频率和 FLS 恶化的改善。
在两个国家,共有 100 名受访者完成了调查。在英国和法国,分别将残疾进展时间从 2 年提高到 4 年、将注射频率从“每日”降低到“每两周”一次、将 FLS 从每次注射后 3 天减少到无,其相对重要性分别为 2.9 和 2.6、3.0 和 3.5、2.5 和 3.1。考虑到研究中包含的范围,这些属性的变化比评估的其他大多数属性的变化更为重要。
MS 治疗的注射频率降低和 FLS 减少对患者可能与疗效改善一样重要。