Patient preferences in chronic immune-mediated inflammatory diseases potentially treated with biological drugs: discrete choice analysis using real-world data analysis

ABSTRACT

Objectives

Immune-mediated inflammatory diseases (IMIDs) represent a high burden due to their chronicity, high prevalence, and associated comorbidities. Chronic patients’ preferences must be considered in IMIDs treatment and follow-up. The objective of this study was to further understand patient’s preferences in private settings.

Methods

A literature review was performed to choose the most relevant criteria for patients. A D-efficient discrete choice experiment was designed to elicit preferences of adult patients with IMIDs and potential biological treatment prescription. Participants were collected from private practices (rheumatology, dermatology, and gastroenterology) from February to May 2022. Patients chose between option pairs, characterized by six health-care attributes, as well as monthly out-of-pocket drug price. Responses were analyzed through a conditional logit model.

Results

Eighty-seven patients answered the questionnaire. The most frequent pathologies were Rheumatoid Arthritis (31%) and Psoriatic Arthritis (26%). The most relevant criteria were choosing the preferred physician (OR 2.25 [SD0.26]); reducing time until visit with specialist (OR 1.79 [SD0.20]), access through primary care (OR 1.60 [SD0.08]), and an increase in monthly out-of-pocket price from 100€ to 300€ (OR 0.55 [SD0.06]) and to 600€ (OR 0.08 [SD0.02]).

Conclusions

Chronic IMIDs patients showed a preference toward a faster, personalized service, even with a trade-off in terms of out-of-pocket price

KEYWORDS:

• Adalimumab
• immune-mediated inflammatory diseases
• biologics
• patient preferences
• private s`etting

Article highlights

• The incorporation of patient preferences has gained wider public attention due to its positive impact on health-care service outcomes.

• A survey (n:87) was conducted to identify patient preferences related to willingness to pay.

• The results contributed to outlining six main attributes that highlight the contrast between public and private health-care systems, enabling informed decision-making based on patients’ needs.

• Attributes such as price, freedom of choice for preferred physicians, or a decrease in waiting lists were found to be highly relevant.

• Attributes such as maintaining the same doctor in the long-term or waiting lists for specific tests conducted by specialists were not as conclusive.

Declaration of interest

D Ginard-Vicens has earned fees from: AbbVie, Pfizer, Fresenius, Galapagos, Lilly, and Novartis. J Tornero-Molina has earned fees from: Biogen, Astra-zeneca, and LEO Pharma. L Fernández-Fuente-Bursón has earned fees from: Janssen, Stada, Lilly, Fresenius, and Theramex. ML González-Gómez has earned fees from: Lilly, Sanofi y Stada. C Crespo works as a consultant in Axentiva Solutions, a consultancy firm working for several pharmaceutical companies. A Burniol-Garcia works as a consultant in Axentiva Solutions, a consultancy firm working for several pharmaceutical companies. M.A Guigini works for Fresenius Kabi España, S.A.U. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conceptualization: D Ginard-Vicens, J Tornero-Molina, MA Guigini, C Crespo. Methodology: A Burniol-Garcia, C Crespo, investigation D Ginard-Vicens, J Tornero-Molina, L Fernández de la Fuente Bursón, ML González-Gómez, E Moreno, M Salleras. Formal analysis: A Burniol-Garcia, C Crespo. Writing – original draft preparation: A Burniol-Garcia, C Crespo. Writing – review and editing: all. All authors read and approved the final manuscript for publication.

Ethical considerations

All authors accept the responsibilities defined by the International Committee of Medical Journal Editors (ICMJE).

All subjects participated voluntarily and provided their written consent to participate in this study. Ethical approval for this study was obtained from the Balearic Islands Research Ethics Committee (Code: IB 4598/21 PI).

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2232109

Additional information

Funding

This work was funded by Fresenius Kabi Sain S.L.U.