Patient preferences for topical psoriasis treatments: a discrete choice experiment

Abstract

Background

Topical medication continues to be the most frequently prescribed therapy for psoriasis. However, patients are often dissatisfied with their topical medication, and adherence to this type of therapy is particularly poor.

Objective

To investigate the preferences of patients with psoriasis regarding the process and outcome attributes associated with topical treatments and to assess influencing factors.

Methods

A discrete choice experiment was conducted to analyze patient preferences for topical psoriasis treatments based on outcome attributes (probabilities of 90% improvement, 50% improvement, skin atrophy and skin irritation) and process attributes (treatment cost not covered by health insurance, treatment duration, location, frequency and formulation).

Results

The study cohort (N = 184) considered probabilities of 50% (Relative Importance Score (RIS)=41.0) and 90% (RIS = 33.9) improvement most important, followed by risk of skin atrophy (RIS = 26.4) and treatment cost (RIS = 22.2). Treatment location (RIS = 18.9), risk of skin irritation (RIS = 16.2), treatment frequency (RIS = 13.3) and formulation (RIS = 11.0) were considered less relevant. Income, cardiovascular disease, number of visits and current topical therapy influenced treatment preferences.

Conclusions

Averaged across the cohort, participants preferred an efficient topical treatment associated with a low risk of skin atrophy and reasonable personal expenses. Individual preferences should be integrated into a shared decision-making process about psoriasis treatment.

Keywords:

• Discrete choice experiment
• preferences
• psoriasis
• topical therapy

Acknowledgement

The authors would like to thank all participants.

Disclosure statement

S. Hoelker, N. Ninosu and S. Buettner declare no conflicts of interest. W. K. Peitsch served as an investigator for AbbVie, Array Biopharma, Boehringer Ingelheim, Eli Lilly, Janssen-Cilag, MSD, Novartis, Pfizer and UCB Pharma, was a member of advisory boards of BMS, Eli Lilly, LEO Pharma, MSD, Novartis, Pfizer, Roche, Sanofi and UCB Pharma, received honoraria from ALK-Abello, AbbVie, Biotest, BMS, Janssen-Cilag, MSD, Novartis, Pfizer, Dr. Pfleger and Roche, and received support for conferences from AbbVie, Actelion, ALK-Abello, Alma Lasers, Almirall Hermal, ARC Lasers, Asclepion, Beiersdorf, BMS, Celgene, Dermapharm, Dermasence, Eli Lilly, Galderma, GSK, Immunocore, Janssen-Cilag, L’Oreal, La Roche Posay, LEO Pharma, Medac, MSD, Mylan, Novartis, Pierre Fabre, P&M Cosmetics, Pfizer, Roche, Sanofi and Sun Pharma. M.-L. Schaarschmidt has been an advisor to and/or received speakers’ honoraria from and/or received grants from and/or participated in clinical trials by the following companies: Abbvie, Allmirall, Biogen Inc., BMS GmbH, Böhringer-Ingelheim, Celgene, Eli Lilly, Janssen-Cilag GmbH, Merck Serono GmbH, MSD SHARP & DOHME GmbH, Novartis Pharma GmbH and UCB. The disclosed conflicts of interest have not influenced the content of this manuscript.