Abstract
BackgroundMultiple Myeloma (MM) is a cancer characterised by the proliferation of malignant plasma cells in the bone marrow. This study examined the treatment preferences of people living with MM compared to the treatment preferences of other groups involved in treatment decision making, including carers, as well as physicians and nurses who treat people living with MM in Australia.MethodsData were collected using discrete choice experiments (DCEs) through an online survey. The DCEs presented participants with a traditional treatment generic choice experiment (e.g., treatment A vs treatment B), focusing on the clinical benefits of treatments and the associated risks. The attributes and levels of the attributes were selected based on previous research, literature review, qualitative research and expert opinion. The DCE data were modelled using a Latent Class Model (LCM).ResultsThe model revealed significant heterogeneity in preferences for treatment attributes. In particular, overall survival, remission period and annual out of pocket cost were the attributes with the most variation. In comparison to people living with MM, carers were less cost-sensitive and more concerned with quality of life (remission period). Physicians and nurses were generally more concerned with overall survival and more cost sensitive than people living with MM.ConclusionsThis study demonstrated that not all people living with MM valued the same treatment attributes equally. Further, not all groups involved in MM treatment decision making had preference alignment on all treatment attributes. This has important implications for healthcare policy decisions and shared decision making. Results from this study could be used to guide decisions around the value of new MM medicines or the medical plan surrounding the needs of those living with MM, as well as those caring for them.
Highlights
Multiple Myeloma (MM) is a cancer characterised by the proliferation of malignant plasma cells in the bone marrow
An online survey with a Discrete Choice Experiment (DCE) component was designed to understand the treatment preferences of people living with MM and that of their care team
Participants One hundred twenty-four people living with MM, 44 carers, 28 haematologists, and 34 nurses who were involved in the care and treatment of people living with MM completed the DCE task
Summary
Multiple Myeloma (MM) is a cancer characterised by the proliferation of malignant plasma cells in the bone marrow. While there is no cure for MM, recent advances in the understanding of the disease have resulted in new treatment options [3, 4] and subsequently, greater survival outcomes for people living with MM [4, 5] This has led to a paradigm shift where MM is considered a chronic condition, with people more likely to use multiple combinations of treatments, over longer periods of time. MM can be treated with several classes of treatments including immunomodulators, proteasome inhibitors, monoclonal antibodies, and others [3, 5] These treatments differ with respect to clinical outcomes such as the average length of survival, potential side effects, as well as non-clinical aspects such as the mode and frequency of administration, and whether it is used as a monotherapy or combination therapy
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