How do patients value features of biological medicine in rheumatoid arthritis? A discrete choice experiment

ABSTRACT

Background

The aim of this study was to quantify the preference of the patients regarding biological DMARDs.

Research design and methods

Patients’ preferences were assessed using a discrete choice experiment. Eighteen different surveys describing eight attributes were designed using experimental design methods. Each survey presented eight choice tasks with two options for patients to choose one. A conditional logit model was used to calculate relative importance and willingness to pay. Subgroup analysis was conducted to evaluate the effect of the patients’ characteristic on their preferences.

Results

A total of 306 patients were included in the study. All attributes had significant effects on the patients’ choices. The most important feature was the ability to preserve physical function. The least important feature was the route of administration. Surprisingly, the out-of-pocket cost was one of the last priorities for respondents. According to the relative importance calculations, 80% of the patients’ preferences can be obtained by clinical attributes. Based on subgroup analysis, the most important patient characteristic that affected their choices was the monthly out-of-pocket history.

Conclusions

Different features of treatment had different effects on the patients’ preferences. Quantification of the impact of each attribute not only revealed their relative importance but also determined the trade-off rate among them.

KEYWORDS:

• Biological medicine
• conjoint analysis
• discrete choice
• patient preferences: rheumatoid arthritis
• patient preferences
• rheumatoid arthritis

Acknowledgments

It was a part of a PhD thesis that was supported by Tehran University of Medical Sciences.

Declaration of interest

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

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

Author contributions

A Kebriaeezadeh, A Jamshidi and S Nikfar Conceptualized the study; S Zartab, M Toroski designed the survey; S Zartab, V Varahrami analyzed the data, B Fatemi contributed in preparing original draft; A Kebriaeezadeh and S Nikfar reviewed and edited the writing; A Kebriaeezadeh supervised all processes. All authors approved the final version of the manuscript for publication.

Ethics approval

The study was confirmed by the Ethics Committee of Tehran University of Medical Sciences (TUMS): IR.TUMS.VCR.REC.1397.756.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2210836.

Additional information

Funding

This paper was not funded.