title: Patients' Preferences Related to Benefits, Risks, and Formulations of Schizophrenia Treatment.
abstract: OBJECTIVE
  The objective of this study was to quantify patients' preferences related to benefits and risks of antipsychotic treatments for schizophrenia and to assess the relative importance of treatment attributes and adherence.
  
  
  METHODS
  Treatment-related preferences among U.S. residents with a self-reported physician diagnosis of schizophrenia were assessed via a discrete-choice experiment. Patients chose between competing hypothetical scenarios characterized by improvements in positive symptoms, negative symptoms, and social functioning; incidence of weight gain, extrapyramidal symptoms (EPS), hyperprolactinemia, and hyperglycemia; and medication formulation. Preferences were estimated by using a random-parameters logit model, and the impact of adherence was estimated with conditional logit models.
  
  
  RESULTS
  The final sample consisted of 271 patients. Complete improvement in positive symptoms was the most preferred outcome (relative importance score of 10.0), followed by elimination of hyperglycemia (3.6, 95% confidence interval [CI]=2.6-4.6), improvement in negative symptoms (3.0, CI=1.6-4.3), reduced weight gain (2.6, CI=1.2-4.0), avoidance of hyperprolactinemia (1.7, CI=.9-2.6), improved social functioning (1.5, CI=.4-2.5), and avoidance of EPS (1.0, CI=.3-1.8). Patients judged a daily pill superior to monthly injections (p<.01) and monthly injections superior to injections every three months (p<.01) for adherent patients and monthly injections superior to a daily pill for nonadherent patients (p=.01).
  
  
  CONCLUSIONS
  Persons who self-identified as having schizophrenia judged improvement in positive symptoms as the most important treatment benefit. Hyperglycemia was identified as the most important adverse event. Patients judged oral formulations to be better than monthly injections for adherent patients and monthly injections to be a better choice for nonadherent patients.
authors.affiliation: Dr. Levitan is with Janssen Research and Development, L.L.C., Titusville, New Jersey (e-mail: blevitan@its.jnj.com ). Dr. Markowitz was with Janssen Scientific Affairs, L.L.C., Titusville, and Ms. Mohamed and Dr. Johnson were with RTI Health Solutions, Research Triangle Park, North Carolina, during a large portion of the time that the study was conducted. Dr. Markowitz is now with the Department of Biopharma Development Solutions, CNS Practice, UCB Biosciences, Inc., Raleigh, North Carolina. Ms. Mohamed is now with Global Health Economics and Outcomes Research, Specialty Medicine, Bayer Healthcare Pharmaceuticals, Inc., Whippany, New Jersey. Dr. Johnson is now with the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina. Dr. Alphs is with Janssen Scientific Affairs, L.L.C. Dr. Citrome is with the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. Dr. Bridges is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
authors.forename: Bennett
authors.initials: B
authors.lastname: Levitan
authors.affiliation: Dr. Levitan is with Janssen Research and Development, L.L.C., Titusville, New Jersey (e-mail: blevitan@its.jnj.com ). Dr. Markowitz was with Janssen Scientific Affairs, L.L.C., Titusville, and Ms. Mohamed and Dr. Johnson were with RTI Health Solutions, Research Triangle Park, North Carolina, during a large portion of the time that the study was conducted. Dr. Markowitz is now with the Department of Biopharma Development Solutions, CNS Practice, UCB Biosciences, Inc., Raleigh, North Carolina. Ms. Mohamed is now with Global Health Economics and Outcomes Research, Specialty Medicine, Bayer Healthcare Pharmaceuticals, Inc., Whippany, New Jersey. Dr. Johnson is now with the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina. Dr. Alphs is with Janssen Scientific Affairs, L.L.C. Dr. Citrome is with the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. Dr. Bridges is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
authors.forename: Michael
authors.initials: M
authors.lastname: Markowitz
authors.affiliation: Dr. Levitan is with Janssen Research and Development, L.L.C., Titusville, New Jersey (e-mail: blevitan@its.jnj.com ). Dr. Markowitz was with Janssen Scientific Affairs, L.L.C., Titusville, and Ms. Mohamed and Dr. Johnson were with RTI Health Solutions, Research Triangle Park, North Carolina, during a large portion of the time that the study was conducted. Dr. Markowitz is now with the Department of Biopharma Development Solutions, CNS Practice, UCB Biosciences, Inc., Raleigh, North Carolina. Ms. Mohamed is now with Global Health Economics and Outcomes Research, Specialty Medicine, Bayer Healthcare Pharmaceuticals, Inc., Whippany, New Jersey. Dr. Johnson is now with the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina. Dr. Alphs is with Janssen Scientific Affairs, L.L.C. Dr. Citrome is with the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. Dr. Bridges is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
authors.forename: Ateesha F
authors.initials: AF
authors.lastname: Mohamed
authors.affiliation: Dr. Levitan is with Janssen Research and Development, L.L.C., Titusville, New Jersey (e-mail: blevitan@its.jnj.com ). Dr. Markowitz was with Janssen Scientific Affairs, L.L.C., Titusville, and Ms. Mohamed and Dr. Johnson were with RTI Health Solutions, Research Triangle Park, North Carolina, during a large portion of the time that the study was conducted. Dr. Markowitz is now with the Department of Biopharma Development Solutions, CNS Practice, UCB Biosciences, Inc., Raleigh, North Carolina. Ms. Mohamed is now with Global Health Economics and Outcomes Research, Specialty Medicine, Bayer Healthcare Pharmaceuticals, Inc., Whippany, New Jersey. Dr. Johnson is now with the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina. Dr. Alphs is with Janssen Scientific Affairs, L.L.C. Dr. Citrome is with the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. Dr. Bridges is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
authors.forename: F Reed
authors.initials: FR
authors.lastname: Johnson
authors.affiliation: Dr. Levitan is with Janssen Research and Development, L.L.C., Titusville, New Jersey (e-mail: blevitan@its.jnj.com ). Dr. Markowitz was with Janssen Scientific Affairs, L.L.C., Titusville, and Ms. Mohamed and Dr. Johnson were with RTI Health Solutions, Research Triangle Park, North Carolina, during a large portion of the time that the study was conducted. Dr. Markowitz is now with the Department of Biopharma Development Solutions, CNS Practice, UCB Biosciences, Inc., Raleigh, North Carolina. Ms. Mohamed is now with Global Health Economics and Outcomes Research, Specialty Medicine, Bayer Healthcare Pharmaceuticals, Inc., Whippany, New Jersey. Dr. Johnson is now with the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina. Dr. Alphs is with Janssen Scientific Affairs, L.L.C. Dr. Citrome is with the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. Dr. Bridges is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
authors.forename: Larry
authors.initials: L
authors.lastname: Alphs
authors.affiliation: Dr. Levitan is with Janssen Research and Development, L.L.C., Titusville, New Jersey (e-mail: blevitan@its.jnj.com ). Dr. Markowitz was with Janssen Scientific Affairs, L.L.C., Titusville, and Ms. Mohamed and Dr. Johnson were with RTI Health Solutions, Research Triangle Park, North Carolina, during a large portion of the time that the study was conducted. Dr. Markowitz is now with the Department of Biopharma Development Solutions, CNS Practice, UCB Biosciences, Inc., Raleigh, North Carolina. Ms. Mohamed is now with Global Health Economics and Outcomes Research, Specialty Medicine, Bayer Healthcare Pharmaceuticals, Inc., Whippany, New Jersey. Dr. Johnson is now with the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina. Dr. Alphs is with Janssen Scientific Affairs, L.L.C. Dr. Citrome is with the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. Dr. Bridges is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
authors.forename: Leslie
authors.initials: L
authors.lastname: Citrome
authors.affiliation: Dr. Levitan is with Janssen Research and Development, L.L.C., Titusville, New Jersey (e-mail: blevitan@its.jnj.com ). Dr. Markowitz was with Janssen Scientific Affairs, L.L.C., Titusville, and Ms. Mohamed and Dr. Johnson were with RTI Health Solutions, Research Triangle Park, North Carolina, during a large portion of the time that the study was conducted. Dr. Markowitz is now with the Department of Biopharma Development Solutions, CNS Practice, UCB Biosciences, Inc., Raleigh, North Carolina. Ms. Mohamed is now with Global Health Economics and Outcomes Research, Specialty Medicine, Bayer Healthcare Pharmaceuticals, Inc., Whippany, New Jersey. Dr. Johnson is now with the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina. Dr. Alphs is with Janssen Scientific Affairs, L.L.C. Dr. Citrome is with the Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla. Dr. Bridges is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
authors.forename: John F P
authors.initials: JF
authors.lastname: Bridges
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002755:Choice Behavior; D005260:Female; D006801:Humans; D006943:Hyperglycemia; D007267:Injections; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010820:Physicians; D012559:Schizophrenia / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D014481:United States; D015430:Weight Gain
chemical_list: D014150:Antipsychotic Agents