Xu Yihua, Sudharshan Lavanya, Hsu Ming-Ann, Koenig Andrew S, Cappelleri Joseph C, Liu Wen F, Smith Timothy W, Pasquale Margaret K
Research Science Lead, Comprehensive Health Insights, Humana, Louisville, KY.
Research Consultant, Comprehensive Health Insights, Humana, during the study.
Am Health Drug Benefits. 2018 Nov;11(8):408-417.
As psoriatic arthritis (PsA) treatment choices continue to expand, it is important to consider patient preferences for treatment modalities for PsA. Involving patients in treatment decisions can influence adherence to treatment and outcomes of therapy.
To determine patient preferences for medication attributes prescribed for patients with PsA.
A choice-based conjoint survey was mailed to 2800 randomly selected patients with PsA who were enrolled in Humana Medicare and commercial plans. Patients had been diagnosed with PsA between January 1, 2012, and September 30, 2016. The medication attributes included in the survey were the medication route of administration, frequency of administration, ability to reduce daily joint pain and swelling, likelihood of serious infections, improvement in the patient's ability to perform daily activities, achieving clear or almost clear skin, and cost. Hierarchical Bayesian models were used to score patient preferences after adjusting for demographic and clinical characteristics. The mean attribute importance scores were used to rank patient preferences.
A total of 468 patients (258 with a Medicare plan and 210 with a commercial plan) completed the survey. The top 3 medication attributes for patients in Medicare plans were route of administration, cost, and improvement in the ability to perform daily activities. For patients in commercial plans, the top 3 medication attributes were cost, route of administration, and frequency of administration. Within the top 2 attributes for patients in both plans, the oral route of administration and lower cost were most preferred.
Medication route of administration and cost were the 2 most important considerations for patients diagnosed with PsA who were enrolled in Medicare or commercial plans with Humana. As PsA treatment choices continue to expand, considering patient preferences may improve patient adherence and treatment outcomes and should be considered when making treatment decisions for this patient population.
随着银屑病关节炎(PsA)治疗选择的不断增加,考虑患者对PsA治疗方式的偏好非常重要。让患者参与治疗决策会影响治疗依从性和治疗效果。
确定PsA患者对所开药物属性的偏好。
向2800名随机选择的参加Humana医疗保险和商业保险计划的PsA患者邮寄了基于选择的联合调查。这些患者在2012年1月1日至2016年9月30日期间被诊断为PsA。调查中包含的药物属性有给药途径、给药频率、减轻每日关节疼痛和肿胀的能力、严重感染的可能性、患者进行日常活动能力的改善、皮肤达到清除或几乎清除状态以及成本。在调整人口统计学和临床特征后,使用分层贝叶斯模型对患者偏好进行评分。平均属性重要性得分用于对患者偏好进行排序。
共有468名患者(258名参加医疗保险计划,210名参加商业保险计划)完成了调查。医疗保险计划患者的前三大药物属性是给药途径、成本和进行日常活动能力的改善。对于商业保险计划的患者,前三大药物属性是成本、给药途径和给药频率。在两个计划患者的前两大属性中,口服给药途径和较低成本最受青睐。
给药途径和成本是参加Humana医疗保险或商业保险计划的PsA确诊患者的两个最重要考虑因素。随着PsA治疗选择的不断增加,考虑患者偏好可能会提高患者依从性和治疗效果,在为该患者群体做出治疗决策时应予以考虑。