Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis

A discrete choice experiment among European rheumatologists

Monika Hifinger, M. Hiligsmann, S. Ramiro, V. Watson, J. L. Severens, B. Fautrel, T. Uhlig, R. van Vollenhoven, P. Jacques, J. Detert, J. Canas da Silva, C. A. Scirè, F. Berghea, L. Carmona, M. Péntek, A. Keat, A. Boonen

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. Methods In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety ( probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Results Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Conclusions Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals.

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
DOIs
Publication statusAccepted/In press - May 17 2016

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Patient Preference
Cost effectiveness
Patient Selection
Rheumatoid Arthritis
Economics
Patient treatment
Cost-Benefit Analysis
Experiments
Drug therapy
Therapeutics
Safety
Romania
Portugal
Rheumatologists
Hungary
Belgium
Norway
Sweden
Netherlands
Spain

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

Cite this

Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis : A discrete choice experiment among European rheumatologists. / Hifinger, Monika; Hiligsmann, M.; Ramiro, S.; Watson, V.; Severens, J. L.; Fautrel, B.; Uhlig, T.; van Vollenhoven, R.; Jacques, P.; Detert, J.; Canas da Silva, J.; Scirè, C. A.; Berghea, F.; Carmona, L.; Péntek, M.; Keat, A.; Boonen, A.

In: Annals of the Rheumatic Diseases, 17.05.2016.

Research output: Contribution to journalArticle

Hifinger, M, Hiligsmann, M, Ramiro, S, Watson, V, Severens, JL, Fautrel, B, Uhlig, T, van Vollenhoven, R, Jacques, P, Detert, J, Canas da Silva, J, Scirè, CA, Berghea, F, Carmona, L, Péntek, M, Keat, A & Boonen, A 2016, 'Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: A discrete choice experiment among European rheumatologists', Annals of the Rheumatic Diseases. https://doi.org/10.1136/annrheumdis-2016-209202
Hifinger, Monika ; Hiligsmann, M. ; Ramiro, S. ; Watson, V. ; Severens, J. L. ; Fautrel, B. ; Uhlig, T. ; van Vollenhoven, R. ; Jacques, P. ; Detert, J. ; Canas da Silva, J. ; Scirè, C. A. ; Berghea, F. ; Carmona, L. ; Péntek, M. ; Keat, A. ; Boonen, A. / Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis : A discrete choice experiment among European rheumatologists. In: Annals of the Rheumatic Diseases. 2016.
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abstract = "Objective To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. Methods In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety ( probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Results Responses of 559 rheumatologists from 12 European countries were included in the analysis (49{\%} females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57{\%} disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43{\%} disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Conclusions Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals.",
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T2 - A discrete choice experiment among European rheumatologists

AU - Hifinger, Monika

AU - Hiligsmann, M.

AU - Ramiro, S.

AU - Watson, V.

AU - Severens, J. L.

AU - Fautrel, B.

AU - Uhlig, T.

AU - van Vollenhoven, R.

AU - Jacques, P.

AU - Detert, J.

AU - Canas da Silva, J.

AU - Scirè, C. A.

AU - Berghea, F.

AU - Carmona, L.

AU - Péntek, M.

AU - Keat, A.

AU - Boonen, A.

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N2 - Objective To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. Methods In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety ( probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Results Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Conclusions Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals.

AB - Objective To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. Methods In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety ( probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Results Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Conclusions Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals.

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