Myeloma Patient Value Mapping: A Discrete Choice Experiment on Myeloma Treatment Preferences in the UK.

BACKGROUND

Myeloma is an incurable life-threatening hematological cancer. Recent treatment developments have seen improvements in survival; however, while patients are living longer, they are living with symptoms and treatment side effects.

OBJECTIVE

To evaluate myeloma patients' preferences for treatment using a discrete choice experiment (DCE). This study set out to define the relative importance of key treatment attributes, characterize the risk-benefit trade-offs in patients' decision-making, and to analyze the predictive power of basic demographic factors.

METHODS

Four hundred seventy-five myeloma patients in the UK were invited to participate by Myeloma UK. Data were collected using DCEs through an online survey. The DCEs presented patients with 10 choice scenarios, each with 2 treatment options described by 7 attributes, and a "no treatment" option. The DCE data were modelled using a latent class model (LCM). The effects of demographic characteristics were also examined.

RESULTS

Not surprisingly, average survival was most important to all patients but there were significant contrasts between the class preferences. The LCM revealed two classes of patients. Patients in Class 1 placed greater importance on average survival and mild-to-moderate side effects, whereas patients in Class 2 focused on the mode of administration and the average out-of-pocket costs. Patients living with others and those diagnosed in the last 5 years were more likely to be in Class 1.

CONCLUSION

Different treatment features were not valued equally among all myeloma patients. This has important implications for healthcare policy decisions and could be used to guide decisions around the value of new myeloma medicines.

Informations de copyright

© 2020 Fifer et al.

Déclaration de conflit d'intérêts

Jayne Galinsky and Sarah Richard were both employees of Myeloma UK. Simon Fifer is a Director of CaPPRe who were contracted by Myeloma UK to design the experiment, provide data management and conduct the analysis. Simon Fifer reports grants from Myeloma UK, during the conduct of the study; CaPPRe fees from Abbvie, Amgen, AstraZeneca, Celgene, GSK, Ipsen, Janssen, Roche, Sanofi, and Shire, outside the submitted work. The authors report no other conflicts of interest in this work.