POS-318 PATIENT PREFERENCES FOR RISKS AND BENEFITS OF MEDICATIONS TO MANAGE ANEMIA OF CHRONIC KIDNEY DISEASE: A DISCRETE CHOICE EXPERIMENT

Abstract

Anemia is a common complication of advanced chronic kidney disease (CKD) and is associated with reduced health-related quality of life and early mortality. To better understand treatment attributes that matter most in complications of anemia of CKD a patient-centric discrete choice experiment (DCE) was conducted among patients with non-dialysis dependent CKD (NDD-CKD). The experiment was conducted to investigate how patients trade-off potential risks and benefits of anaemia medications and how they quantify the value of various medication features through a willingness to pay analysis. Australian and Canadian adults living with NDD-CKD were recruited through an Australian patient advocacy group, Kidney Health Australia, the Canadian Can-SOLVE CKD patient network, and online panels. Those who met the NDD-CKD screening criteria and provided consent completed a 12-scenario DCE through an online survey. The DCE required participants to choose between three hypothetical treatment alternatives labelled by their mode of administration (‘Oral pill’, ‘Subcutaneous injection’ (SC), ‘Intravenous injection’ (IV)). The opt-out option was ‘None of these’ for patients not on an erythropoiesis-stimulating agents (ESA) and ‘Stay on my current medication’ for patients currently on ESA. Figure 1 provides an example scenario presented in the DCE. Participants were shown multiple scenarios and asked to choose their preferred treatment. Participants were told to assume the medications were equally effective in controlling their anemia symptoms. Preferences were assessed using advanced modelling, which allowed for preference heterogeneity between participants. Preliminary results indicate a strong preference for the hypothetical oral pill among NDD-CKD patients. A lower chance of hospitalisation, a lower chance of requiring additional anemia therapy, and reducing the amount of “bad” cholesterol were also preferred by patients and were significant drivers of choice. Simplicity, convenience, and needle fear were included as reasons in the open text provided by patients, for increased patient value of the oral pill above SC and IV injections. Treatment attributes for frequency of administration, personnel, and location of medication collection and administration had lower importance to patients.As expected, patients’ preferences for all modes of administration decreased with increases in monthly out-of-pocket costs over the range $0-$75 AUD and $0-$150 CAD. Final data including similarities and differences between Australian and Canadian patients will be explored. The results of this DCE show that both Australian and Canadian NDD-CKD patients strongly preferred the hypothetical oral pill (holding all else constant). Our findings could be used as evidence to prioritise the most important characteristics of medications for anemia of CKD from the patients’ perspective.