Boeri M, Abraham L, Hauber B, Atkinson J, Bushmakin AG, Cappelleri JC, Russo L, Viktrup L, Walsh D, Turk D. Exploring heterogeneity in preferences for attributes of pharmaceutical treatments for osteoarthritis and chronic low back pain in the United Kingdom; a latent class approach. Presented at the ISPOR 2019 European Conference; November 5, 2019. Copenhagen, Denmark. [abstract] Value Health. 2019 Nov 1; 22(Supplement 3):S923. doi: 10.1016/j.jval.2019.09.2738

OBJECTIVES: Our primary objective was to quantify patients’ preferences for attributes of pharmaceutical treatments for chronic pain (i.e., associated with osteoarthritis [OA] of the hip or knee and chronic low back pain [CLBP]) in the United Kingdom. Our secondary objective was to explore preference heterogeneity.

A discrete-choice experiment was administered online to respondents with a self-reported physician diagnosis of OA and/or CLBP and moderate-to-severe pain. Respondents were presented with a series of choices between two hypothetical treatments, defined by six attributes: effectiveness (pain and symptom control); associated risks (i.e., rapidly progressive osteoarthritis [RPOA], heart attack, physical dependence); mode (pill vs. injection) and frequency of administration; and cost. Latent class analysis was used to segment preferences in the sample, comparing them with results for the average respondent.

RESULTS: The survey was completed by 437 respondents: 171 with OA, 188 with CLBP, and 78 with OA and CLBP. Mean (SD) age was 54.4 (14.3) years. On average, results suggested the following attribute relative importance (mean [SE]): cost (2.6 [0.2]), pain and symptoms control (2.0 [0.2]), risk of physical dependence (1.2 [0.2]), risk of heart attack (0.4 [0.1]), risk of RPOA (0.4 [0.1]), and mode and frequency of administration (0.2 [0.1]). The latent class analysis identified four classes: one class focused on efficacy (33.7%), one on cost (29.4%), one on avoiding risk of physical dependency (19.6%), and one on mode and frequency of administration (17.3%).

CONCLUSIONS: On average, treatment choices were primarily driven by cost, improving efficacy, and avoiding physical dependence. However, we found evidence of preference heterogeneity; that is, different patients focused on different treatment characteristics, suggesting that patient groups may have different priorities when considering treatments for chronic pain. Discussions between doctor and patient may be particularly important to provide information about a treatment aligned with the patient’s preferences.

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