title: Patient, physician, and general population preferences for treatment characteristics in relapsed or refractory chronic lymphocytic leukemia: A conjoint analysis.
abstract: Due to the disease heterogeneity, treatments for chronic lymphocytic leukemia (CLL) have differed with respect to efficacy and toxicity. Limited options have also been available regarding modalities of administration. Our study objective was to estimate preferences for treatment characteristics (or "attributes") in relapsed/refractory (r/r) CLL. Patients, physicians (hematologists/oncologists), and members from the general population from Germany and Sweden completed a conjoint analysis comprising six CLL treatment attributes: (i) overall survival (OS), (ii) progression-free survival (PFS), (iii) fatigue, (iv) nausea, (v) risk of serious infections, and (vi) treatment administration (each described in three levels). We estimated the relative importance of each attribute by fitting a hierarchical Bayesian model. A total of 190 German and 121 Swedish individuals participated. In the pooled sample, OS was the most important attribute (36%), followed by risk of serious infection (21%), treatment administration (13%), fatigue (12%), PFS (11%), and nausea (7%). Treatment administration was more important to patients (all p<0.004), OS was more important to physicians (all p<0.001), and risk of serious infections was more important to the general population than to physicians (p<0.001). Our results could be helpful to align therapeutic decision-making in r/r CLL with patient preferences to improve care satisfaction and treatment compliance.
authors.affiliation: Mapi Group, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: elandfeldt@mapigroup.com.
authors.forename: Erik
authors.initials: E
authors.lastname: Landfeldt
authors.affiliation: Mapi Group, Stockholm, Sweden.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Eriksson
authors.affiliation: Janssen EMEA Business Intelligence, High Wycombe, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Ireland
authors.affiliation: Janssen Health Economics & Market Access EMEA, High Wycombe, UK.
authors.forename: Patience
authors.initials: P
authors.lastname: Musingarimi
authors.affiliation: Adelphi Research UK, Bollington, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Jackson
authors.affiliation: Adelphi Research UK, Bollington, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Tweats
authors.affiliation: Janssen Health Economics & Market Access EMEA, Neuss, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Gaudig
mesh_terms: D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000473:pathology / Q000628:therapy*; D012008:Recurrence
keywords: Clinical practice; Decision-making; Discrete-choice experiment; Hematology; Leukemia