PRS91 - EVALUATING PATIENT PREFERENCES OF MAINTENANCE THERAPY FOR THE TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN GERMANY: A DISCRETE CHOICE EXPERIMENT

Abstract

With new single-inhaler triple therapies available for treatment of COPD, patient preferences can be used to inform treatment decisions. This study elicited patient preferences for different attributes of COPD treatments using a discrete choice experiment (DCE) in the UK, Germany and USA. This abstract presents results from Germany only. Following qualitative research in patients with COPD, attributes describing features of COPD maintenance treatments were identified: ease of inhaler use, number of exacerbations in the next year, daily frequency of inhaler use, number of different inhalers used, out-of-pocket costs, and side-effects. The online DCE survey comprised 18 choice sets with logical (dominant) choice and consistency checks, along with demographic and disease history questions. Cognitive debriefing interviews and a pilot study confirmed survey feasibility. The final DCE survey was completed by 150 patients with moderate/severe COPD in Germany. DCE data were analysed using mixed-effect logit models. The logical choice check was answered correctly by 146 (97%) participants, who were included in the final models; 112 (75%) selected the same choice within the consistency check. Patients placed most value on a treatment with fewer side effects (OR 5.14 [95% CI: 4.40-6.01] “no side effects” vs. “a lot of side effects”), fewer exacerbations (1.82 [1.69-1.97] per exacerbation per year), and which are easier to use (1.33 [1.16-1.51] “no mistakes” vs. “a lot of mistakes”). Patients also preferred treatments with fewer inhalers (1.17 [1.09-1.25] per inhaler reduction), taken less frequently (1.10 [1.02-1.17] per reduction in daily-dose), and were likely to choose a cheaper option (1.16 [1.07-1.25] per 5% decrease in cost). In principle, patients in Germany with COPD place most importance on the avoidance of side effects and reduction of symptoms when choosing a treatment. However, ease and frequency of use, inhaler number, and cost were also important drivers of choice.