https://orcid.org/0000-0002-3144-8938
Abstract
Introduction
Several on-demand treatments are available for management of “OFF” episodes in patients with Parkinson’s disease (PD). We evaluated patients’ preferences for features of theoretical on-demand treatment options.
Methods
In a discrete choice experiment, US adults with self-reported PD of ≥5 years, or <5 years with “OFF” episodes, taking oral carbidopa/levodopa, selected between pairs of theoretical on-demand treatments that varied by mode of administration (with and without mode-specific adverse events [AEs]), time to FULL “ON,” duration of “ON,” and out-of-pocket cost for a 30-day supply. Data were analyzed with a random parameters logit model; results were used to calculate relative importance of treatment attributes, preference shares, and willingness to pay.
Results
Among 300 respondents, 98% had “OFF” episodes. Across the range of attribute levels included in the survey, avoiding $90 cost was most important to respondents, followed by a preferable mode of administration with associated AEs and decreasing time to FULL “ON.” Duration of “ON” was relatively less important. On average, respondents preferred a theoretical dissolvable sublingual film versus other theoretical treatments with alternative modes of administration. Respondents were willing to pay $28–$52 US dollars to switch from least- to more-preferred mode of administration with associated AEs, $58 to reach FULL “ON” in 15 versus 60 min, and $9 to increase duration of FULL “ON” from 1 to 2 h.
Conclusion
Respondents with PD valued lower out-of-pocket cost and a sublingual mode of administration with its associated AEs when choosing an on-demand treatment for “OFF” episodes.
Acknowledgments
The authors acknowledge the patients who participated in this research, as well as their families and caregivers. The authors acknowledge Kimberly Moon of RTI Health Solutions for overall project management. Medical writing and editorial support were provided by RTI Health Solutions and The Lockwood Group (Stamford, CT, USA) and were supported by funding from Sunovion Pharmaceuticals Inc. This research was presented in part at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Virtual Congress, May 18–20, 2020, and the International Congress of Parkinson’s Disease and Movement Disorders (MDS) Virtual Congress, September 12–16, 2020.
Author Contributions
AT, JS, JC, and CM contributed to the study concept and design. All authors participated in data acquisition, analysis, or interpretation. JS, JC, CL, and CM performed the statistical analysis. All authors were involved in the drafting and critical review of the manuscript, agreed on the target journal, approved the final version, and agreed to be accountable for all aspects of the work.
Disclosure
AT and EP are salaried employees of Sunovion Pharmaceuticals Inc. JS was a salaried employee of RTI Health Solutions when the study was conducted and is now affiliated with Duke Clinical Research Institute, Duke University, Durham, NC, USA. JC, CL, and CM are salaried employees of RTI Health Solutions. The authors report no other conflicts of interest in this work.