EVALUATING PATIENT PREFERENCES OF MAINTENANCE THERAPY FOR THE TREATMENT OF COPD: A DISCRETE CHOICE EXPERIMENT

Abstract

SESSION TITLE: Obstructive Lung Diseases 3 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: With new single-inhaler triple therapies available for maintenance treatment of advanced COPD and a wide variety of existing treatments, which can vary in terms of regimen and number of inhalers, improved understanding of patient preferences can be used to inform physicians’ prescribing decisions. As part of a wider effort to understand patient preference in both the USA and Europe, a study was conducted in the USA, UK and Germany using discrete choice experiment (DCE) methodology to assess patient treatment preferences in COPD. This abstract presents results from the USA only. METHODS: Following qualitative research in patients with COPD, attributes describing features of COPD maintenance treatments were identified: ease of inhaler use, number of exacerbations, frequency of inhaler use, number of different inhalers used, side-effects, and out of pocket costs. The DCE experimental design comprised 18 choice sets with logical (dominant) choice and consistency checks also included. Demographic and disease history data were collected and the survey was administered online. Cognitive debriefing interviews and a pilot study concluded that the survey was feasible to conduct and easily understood by respondents. The final DCE survey was completed by 150 patients in the USA recruited from patient panels. Responses to the DCE were analysed using mixed-effect logit models with the results expressed as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Of the 150 US respondents, 147 (98%) answered the logical choice check correctly and were included in the final models; 114 (76%) selected the same choice within the consistency check. Patients placed most value on an inhaler reducing exacerbation rates (OR 0.59 [95% CI: 0.54-0.65] per exacerbation per year) and avoiding a lot of side effects (0.12 [0.10-0.16] versus “no side effects”). Patients preferred treatments with fewer inhalers (0.67 [0.61-0.73] per inhaler), taken less frequently (0.78 [0.71-0.85] per daily dose), and were also likely to opt for a cheaper option if the efficacy of their treatment is not compromised (1.22 [1.12-1.33] per 5% decrease in cost). CONCLUSIONS: This study suggests that patients in the USA with COPD may place highest value on the improvement in efficacy and avoidance of side effects when choosing a treatment. They also recognised the benefit of an inhaler that is used less frequently, is less costly, and is easier to use. CLINICAL IMPLICATIONS: Patient inhaler preference is important when selecting COPD treatment as preference for an inhaler may improve treatment compliance. Patients in the USA preferred efficacious and safe, easy to use maintenance therapy for the treatment of their COPD. DISCLOSURES: No relevant relationships by Helen Doll, source=Web Response Employee relationship with GSK Please note: >$100000 Added 03/01/2018 by Necdet Gunsoy, source=Web Response, value=Salary Employee relationship with GSK Please note: $20001 - $100000 Added 03/01/2018 by Necdet Gunsoy, source=Web Response, value=Shares Employee relationship with GlaxoSmithKline Please note: >$100000 Added 03/01/2018 by Afisi Ismaila, source=Web Response, value=Salary Employee relationship with GSK Please note: >$100000 Added 03/01/2018 by Paul Jones, source=Web Response, value=Salary No relevant relationships by Hannah Lewis, source=Web Response No relevant relationships by Samuel Llewellyn, source=Web Response Employee relationship with GSK Please note: $20001 - $100000 Added 03/01/2018 by Melanie Schroeder, source=Web Response, value=Salary