Nguyen Chuyen Thi Hong, Thi Mai Nguyen Xuan, The Van Trung
Department of Dermatology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
Acta Derm Venereol. 2025 May 7;105:adv42840. doi: 10.2340/actadv.v105.42840.
Psoriasis is a chronic autoimmune disease that significantly impairs patients' quality of life. With the growing availability of biologic drugs - each varying in efficacy, safety, dosing, and cost - treatment decisions have become increasingly complex. A study conducted from March to July 2024 surveyed 302 Vietnamese patients with moderate to severe psoriasis to assess preferences for biologic therapies. Using a discrete choice experiment (DCE), participants evaluated 6 treatment attributes: short-term efficacy, long-term efficacy, sustained efficacy after drug withdrawal, frequency of administration, copayment, and risk of serious infection. Preference data were analysed using conditional logit models. Analysis revealed that treatment cost (relative importance [RI]: 31.4%) and long-term efficacy (RI: 25.3%) were the most critical factors influencing patient decisions, while sustained efficacy after withdrawal and early onset of efficacy were less impactful. Long-term efficacy and cost consistently ranked highest across all patient subgroups, with variations depending on demographic and clinical characteristics. These findings provide practical guidance for clinicians to incorporate patient preferences into the selection of biologic therapies, with particular emphasis on treatment cost and long-term efficacy. The significant influence of treatment cost also highlights the need for healthcare policymakers in Vietnam to enhance reimbursement policies and financial support programmes, improving access and equity in psoriasis care.
银屑病是一种慢性自身免疫性疾病，严重损害患者的生活质量。随着生物药物的可及性不断提高——每种药物在疗效、安全性、给药方式和成本方面各不相同——治疗决策变得越来越复杂。一项于2024年3月至7月进行的研究，对302名越南中重度银屑病患者进行了调查，以评估他们对生物疗法的偏好。通过离散选择实验（DCE），参与者评估了6个治疗属性：短期疗效、长期疗效、停药后的持续疗效、给药频率、自付费用以及严重感染风险。使用条件logit模型对偏好数据进行分析。分析显示，治疗成本（相对重要性[RI]：31.4%）和长期疗效（RI：25.3%）是影响患者决策的最关键因素，而停药后的持续疗效和疗效的早期显现影响较小。长期疗效和成本在所有患者亚组中始终排名最高，具体情况因人口统计学和临床特征而异。这些发现为临床医生将患者偏好纳入生物疗法选择提供了实用指导，尤其强调治疗成本和长期疗效。治疗成本的重大影响也凸显了越南医疗政策制定者加强报销政策和财政支持计划的必要性，以改善银屑病治疗的可及性和公平性。
