title: A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany.
abstract: OBJECTIVE
  The aim of this study was to assess the relative importance of features of a hypothetical injectable disease-modifying treatment for patients with multiple sclerosis using a discrete-choice experiment.
  
  
  METHODS
  German residents at least 18 years of age with a self-reported physician diagnosis of multiple sclerosis completed a 25-30 minute online discrete-choice experiment. Patients were asked to choose one of two hypothetical injectable treatments for multiple sclerosis, defined by different levels of six attributes (disability progression, the number of relapses in the next 4 years, injection time, frequency of injections, presence of flu-like symptoms, and presence of injection-site reactions). The data were analyzed using a random-parameters logit model.
  
  
  RESULTS
  Of 202 adults who completed the survey, results from 189 were used in the analysis. Approximately 50% of all patients reported a diagnosis of relapsing-remitting multiple sclerosis, and 31% reported secondary progressive multiple sclerosis. Approximately 71% of patients had current or prior experience with injectable multiple sclerosis medication. Approximately 53% had experienced flu-like symptoms caused by their medication, and 47% had experienced mild injection-site reactions. At least one significant difference was seen between levels in all attributes, except injection time. The greatest change in relative importance between levels of an attribute was years until symptoms get worse from 1 to 4 years. The magnitude of this difference was about twice that of relapses in the next 4 years, frequency of injections, and flu-like symptoms.
  
  
  CONCLUSIONS
  Most attributes examined in this experiment had an influence on patient preference. Patients placed a significant value on improvements in the frequency of dosing and disability progression. Results suggest that changes in injection frequency can be as important as changes in efficacy and safety attributes. Understanding which attributes of injectable therapies influence patient preference could potentially improve outcomes and adherence in patients with multiple sclerosis.
authors.affiliation: RTI Health Solutions, 200 Park Offices Drive, PO Box 12194, Research Triangle Park, NC 27709, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Poulos
authors.affiliation: Biogen, Cambridge, MA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kinter
authors.affiliation: RTI Health Solutions, Research Triangle Park, NC, USA.
authors.forename: Jui-Chen
authors.initials: JC
authors.lastname: Yang
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: John F P
authors.initials: JF
authors.lastname: Bridges
authors.affiliation: RTI Health Solutions, Research Triangle Park, NC, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Posner
authors.affiliation: Biogen, Ismaning, Germany.
authors.forename: Erika
authors.initials: E
authors.lastname: Gleißner
authors.affiliation: Hochschule Neubrandenburg, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Mühlbacher
authors.affiliation: University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Kieseier
keywords: choice-format conjoint analysis; discrete-choice experiment; injectable treatments; multiple sclerosis; stated preference