Tradeoffs and decision-making in moderate to severe psoriasis for oral versus injectable treatments: data from patients and dermatologists in Australia

Abstract

Background Oral systemic and injectable biologic treatments are available in Australia to treat moderate to severe psoriasis. Objective To examine how patients and dermatologists in Australia choose between oral and injectable treatments for psoriasis. Methods In this discrete choice experiment (DCE), adults with moderate to severe psoriasis and dermatologists were asked to choose between 2 treatments labeled by mode of administration (‘oral’ or ‘subcutaneous injection’), each with randomly assigned levels for 9 treatment attributes. Needle fear was rated by patients. Results Completed surveys from 178 patients and 43 dermatologists were included in the analysis. Symptom reduction, safety, and mode of administration were attributes found to have a significant impact on treatment choice; dosing frequency was a significant attribute for the injectable option. When treatment attributes were held equal, patients and dermatologists preferred oral versus injectable treatments for moderate disease. Patients with higher levels of needle fear were more likely to favor an oral treatment versus patients with lower levels of needle fear. Limitations Participation bias may limit the generalizability of these findings. Conclusion Participants preferred oral over injectable treatment for moderate psoriasis. These findings corroborate the need for efficacious oral therapies to treat the disease.