Summarizing Patient Preferences for the Competitive Landscape of Multiple Sclerosis Treatment Options.

Publication date: Feb 17, 2020

Objective. Quantitatively summarize patient preferences for European licensed relapsing-remitting multiple sclerosis (RRMS) disease-modifying treatment (DMT) options. Methods. To identify and summarize the most important RRMS DMT characteristics, a literature review, exploratory physician interviews, patient focus groups, and confirmatory physician interviews were conducted in Germany, the United Kingdom, and the Netherlands. A discrete choice experiment (DCE) was developed and executed to measure patient preferences for the most important DMT characteristics. The resulting DCE data (n=799 and n=363 respondents in the United Kingdom and Germany, respectively) were analyzed using Bayesian mixed logit models. The estimated individual-level patient preferences were subsequently summarized using 3 additional analyses: the quality of the choice data was assessed using individual-level R estimates, individual-level preferences for the available DMTs were aggregated into DMT-specific preference shares, and a principal component analysis was performed to explain the patients’ choice process. Results. DMT usage differed between RRMS patients in Germany and the United Kingdom but aggregate patient preferences were similar. Across countries, 42% of all patients preferred oral medications, 38% infusions, 16% injections, and 4% no DMT. The most often preferred DMT was natalizumab (26%) and oral DMT cladribine tablets (22%). The least often preferred were mitoxantrone and the beta-interferon injections (1%-3%). Patient preferences were strongly correlated with patients’ MS disease duration and DMT experience, and differences in patient preferences could be summarized using 8 principle components that together explain 99% of the variation in patients’ DMT preferences. Conclusion. This study summarizes patient preferences for the included DMTs, facilitates shared decision making along the dimensions that are relevant to RRMS patients, and introduces methods in the medical DCE literature that are ideally suited to summarize the impact of DMT introductions in preexisting treatment landscapes.

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Jonker, M.F., Donkers, B., Goossens, L.M.A., Hoefman, R.J., Jabbarian, L.J., de Bekker-Grob, E.W., Versteegh, M.M., Harty, G., and Wong, S.L. Summarizing Patient Preferences for the Competitive Landscape of Multiple Sclerosis Treatment Options. 20234. 2020 Med Decis Making.

Concepts Keywords
Bayesian Purines
Cladribine Organochlorides
Discrete Choice Cladribine
DMT Chemical compounds
Germany Amines
Interferon Drugs
Logit Sclerosis RRMS disease
Mitoxantrone Multiple Sclerosis Treatment
Multiple Sclerosis N,N-Dimethyltryptamine
Natalizumab Multiple sclerosis
Netherlands Preference
Physician Natalizumab
Preference Shares
United Kingdom


Type Source Name
disease MESH Multiple Sclerosis
disease MESH relapsing-remitting multiple sclerosis
drug DRUGBANK Dimethyltryptamine
drug DRUGBANK Natalizumab
drug DRUGBANK Cladribine
drug DRUGBANK Mitoxantrone


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