title: Patient preferences in allergy immunotherapy (AIT) in Germany - a discrete-choice-experiment.
abstract: BACKGROUND
  Allergic Rhinitis (AR) is a common disorder in Europe with Allergic Asthma (AA) as a frequent comorbidity. Allergy immunotherapy (AIT) is the only causal therapy of AR and AA, and can be administered as subcutaneous injections at the physician or as sublingual drops or tablets at home. The usual treatment duration is 3 years.
  
  
  OBJECTIVE
  This study aimed to elicit patient preferences to identify the AIT administration mode preferred by patients.
  
  
  METHODS
  A discrete-choice-experiment (DCE) was developed to determine how people weight different treatment options using a paper-based questionnaire from June to September 2014, including 16 study centres. Main inclusion criteria: >18 years, grass, birch and/or house dust mite AR with moderate to severe symptoms, AIT-naïve and AIT-indicated. DCE-attributes were: Administration form, number and duration of physician visits, frequency of life-threatening anaphylactic shocks, local side-effects and co-payments.
  
  
  RESULTS
  Two-hundred thirty-nine subjects participated, resulting in analysable 1842 choices. All attributes were significant predictors for the treatment-choice. Ranked by importance, the following first three attributes are most preferred by patients: 1(st) Number and duration of physician visits: Fewer visits with shorter duration preferred (0.658*) 2(nd) Frequency of life-threatening anaphylactic shocks: Lower risk of shocks preferred (0.285*) 3(rd) Local side-effects: Preference for rash/swelling on upper arm over itching/swelling under the tongue (0.210*) (*coefficient-size represents relative importance of the attributes)
  
  
  CONCLUSIONS
  The most important attribute is the number and duration of visits to a physician. A lower risk of life-threatening anaphylactic shocks was ranked as the second whereas co-payments and administration form play a limited role.
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Damm
authors.affiliation: ALK-Abelló Arzneimittel GmbH, Griegstraße 75, Haus 25, D-22763, Hamburg, Germany. janina.volk@alk.net.
authors.forename: Janina
authors.identifier: http://orcid.org/0000-0002-0727-5985
authors.initials: J
authors.lastname: Volk
authors.affiliation: ENT Practice am Neckar Dres. Zeuner, Horn & Vasvari, Heidelberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Horn
authors.affiliation: Department of Dermatology and Allergy, University of Bonn, Bonn, Germany.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Allam
authors.affiliation: ALK-Abelló, Hørsholm, Denmark.
authors.forename: Ninette
authors.initials: N
authors.lastname: Troensegaard-Petersen
authors.affiliation: ALK-Abelló, Hørsholm, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Serup-Hansen
authors.affiliation: ALK-Abelló Arzneimittel GmbH, Griegstraße 75, Haus 25, D-22763, Hamburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Winkler
authors.affiliation: ALK-Abelló Arzneimittel GmbH, Griegstraße 75, Haus 25, D-22763, Hamburg, Germany.
authors.forename: Ivonne
authors.initials: I
authors.lastname: Thiessen
authors.affiliation: Xcenda GmbH, Hannover, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Borchert
authors.affiliation: ALK-Abelló Arzneimittel GmbH, Griegstraße 75, Haus 25, D-22763, Hamburg, Germany.|Department for Otorhinolaryngology, Medical Faculty Dresden University, Dresden, Germany.
authors.forename: Eike G
authors.initials: EG
authors.lastname: Wüstenberg
authors.affiliation: Xcenda GmbH, Hannover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mittendorf
keywords: Allergic rhinitis; Allergy immunotherapy; Discrete-choice-experiment; Patient preferences; Sublingual immunotherapy-tablet