title: Patients' preferences for bone metastases treatments in France, Germany and the United Kingdom.
abstract: OBJECTIVE
  The aim of this study was to assess patients' preferences for efficacy, safety, and mode of administration in relation to available bone-targeted agents (BTA) for the prevention of skeletal-related events (SREs) associated with bone metastases in Europe.
  
  
  METHODS
  Adults in France (n = 159), Germany (n = 166), and the United Kingdom (UK; n = 159) with a self-reported physician diagnosis of bone metastases secondary to a solid tumour completed an online discrete- choice experiment survey of ten questions, choosing between pairs of hypothetical BTA profiles. Profiles were defined by five treatment attributes: delay of first SRE, delay of worsening of pain, annual risk of osteonecrosis of the jaw (ONJ), annual risk of renal impairment, and mode of administration. Profiles were generated using an experimental design with known statistical properties. A main-effects random parameters logit (RPL) model was applied to relate participants' choices to the characteristics of the BTA profiles.
  
  
  RESULTS
  The most important treatment attributes for patients across all three countries were time until first SRE, annual risk of renal complications and time until pain worsening. For these attributes, better levels of outcomes were significantly preferred to worse levels (p < 0.05). A 120-minutes infusion every 4 weeks was the least preferred mode of administration. Risk of ONJ was judged by patients in the UK and Germany to be the least important attribute.
  
  
  CONCLUSIONS
  Patients consider delaying SREs, avoiding renal impairment and delaying pain worsening as the most important goals to consider when selecting treatment to prevent the bone complications commonly associated with bone metastases.
authors.affiliation: Global Health Economics, Amgen (Europe) GmbH, Dammstrasse 23, Zug, 6301, Switzerland, hechmati@amgen.com.
authors.forename: Guy
authors.initials: G
authors.lastname: Hechmati
authors.forename: A Brett
authors.initials: AB
authors.lastname: Hauber
authors.forename: Jorge
authors.initials: J
authors.lastname: Arellano
authors.forename: Ateesha F
authors.initials: AF
authors.lastname: Mohamed
authors.forename: Yi
authors.initials: Y
authors.lastname: Qian
authors.forename: Francesca
authors.initials: F
authors.lastname: Gatta
authors.forename: Ian
authors.initials: I
authors.lastname: Haynes
authors.forename: Amit
authors.initials: A
authors.lastname: Bahl
authors.forename: Roger
authors.initials: R
authors.lastname: von Moos
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Body
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D001842:Bone and Bones / Q000473:pathology; D002755:Choice Behavior; D000069448:Denosumab; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D005602:France; D005858:Germany; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007674:Kidney Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000453:epidemiology*; D010146:Pain / Q000188:drug therapy / Q000517:prevention & control*; D010358:Patient Participation; D057240:Patient Preference / Q000523:psychology*; D053245:RANK Ligand / Q000037:antagonists & inhibitors; D016896:Treatment Outcome; D006113:United Kingdom; D000077211:Zoledronic Acid
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D053245:RANK Ligand; D000069448:Denosumab; D000077211:Zoledronic Acid