Boeri M, Szegvari B, Hauber B, Mange B, Mountian I, Schiff M, Maniadakis N. From drug-delivery device to disease management tool: a study of patient preferences for enhanced features in next generation self-injection devices. Presented at the ISPOR 21st Annual European Congress; November 13, 2018. Barcelona, Spain.


OBJECTIVES: Patients may prefer self-injection drug delivery devices with advanced features that help them manage their disease. This study aimed to quantify patient preferences and willingness to pay (WTP) for features differentiating enhanced self-injection devices from standard self-injection pens, and to test for systematic differences among patient subgroups.

METHODS:
This study used a discrete-choice experiment (DCE) to elicit preferences; respondents were presented with 10 choices between three hypothetical alternatives: a free standard disposable self-injection pen, and two reusable self-injection devices with different enhanced feature combinations (including skin sensor, injection speed control, on-screen instructions, injection reminders, electronic log and grip size). Each alternative included out-of-pocket cost to measure WTP. Respondents were patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) recruited in the United Kingdom (UK). Data were analyzed using a random-parameters logit model to estimate preference weights, conditional relative importance and WTP.

RESULTS: Data were collected from 323 respondents: 108 with RA, 103 with PsA, and 112 with axSpA. Devices with enhanced features at lower costs were preferred. On average, respondents preferred reusable devices with all enhanced features (WTP value: £85) over the standard self-injection pen. However, self-injection naïve respondents with RA and PsA were willing to pay up to £210 for these features. Focusing on individual features, the skin sensor was most preferred (£30), followed by injection speed control, injection reminders, and electronic log (~£20), on-screen instructions (<£15), and grip size (~£0). Similar preferences were observed across subgroups except for grip size: axSpA patients preferred small grip (£24), whereas severe PsA and RA patients preferred large grip (£22), perhaps due to hand dexterity problems.

CONCLUSIONS: Overall, patients positively valued reusable self-injection devices with enhanced features. Including enhanced features in self-injection devices may improve patient experience and welfare, potentially increasing treatment adherence and possibly improving clinical and economic outcomes.

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