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Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists

OBJECTIVE: To assess the influence of disease activity of patients with rheumatoid arthritis on treatment choices of rheumatologists in countries with restricted access to expensive, innovative drugs. METHODS: Rheumatologists from Hungary, Romania and UK were invited to complete two consecutive disc...

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Autores principales: Hifinger, Monika, Hiligsmann, Mickael, Ramiro, Sofia, Watson, Verity, Berghea, Florian, Péntek, Márta, Keat, Andrew, Severens, Johan L, Fautrel, Bruno, Boonen, Annelies
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588932/
https://www.ncbi.nlm.nih.gov/pubmed/28912960
http://dx.doi.org/10.1136/rmdopen-2017-000453
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author Hifinger, Monika
Hiligsmann, Mickael
Ramiro, Sofia
Watson, Verity
Berghea, Florian
Péntek, Márta
Keat, Andrew
Severens, Johan L
Fautrel, Bruno
Boonen, Annelies
author_facet Hifinger, Monika
Hiligsmann, Mickael
Ramiro, Sofia
Watson, Verity
Berghea, Florian
Péntek, Márta
Keat, Andrew
Severens, Johan L
Fautrel, Bruno
Boonen, Annelies
author_sort Hifinger, Monika
collection PubMed
description OBJECTIVE: To assess the influence of disease activity of patients with rheumatoid arthritis on treatment choices of rheumatologists in countries with restricted access to expensive, innovative drugs. METHODS: Rheumatologists from Hungary, Romania and UK were invited to complete two consecutive discrete choice experiments with hypothetical drug treatments for two different patient profiles: high and moderate disease activity. Rheumatologists were asked to choose repeatedly between two unlabelled treatment options that differed in five attributes: efficacy (expected improvement and achieved disease activity state), safety (probability of serious adverse events), patient's preference (level of agreement), total medication costs and cost-effectiveness. A heteroscedastic discrete choice model using interaction terms between attribute levels and patient profiles (binary variable) was used to assess the preferences of rheumatologists towards each attribute and the influence of the patient profile. RESULTS: Overall, 148 rheumatologists completed the survey (46% females, mean age 49 years, 49% academic). For both patient profiles, efficacy dominated the treatment choice over patient's preference, safety and economic aspects. However, for patients with high compared with moderate disease activity, the importance of drug efficacy significantly increased (from 48% for moderate to 57% for high disease activity), whereas the importance of patient's preference significantly decreased (from 15% to 11%). No significant differences were observed for economic and safety considerations. CONCLUSION: Rheumatologists were willing to give up some efficacy to account for patient's preference when choosing treatments for patients with moderate compared to high disease activity. Disease activity however did not influence importance of economic aspects in treatment choices.
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spelling pubmed-55889322017-09-14 Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists Hifinger, Monika Hiligsmann, Mickael Ramiro, Sofia Watson, Verity Berghea, Florian Péntek, Márta Keat, Andrew Severens, Johan L Fautrel, Bruno Boonen, Annelies RMD Open Rheumatoid Arthritis OBJECTIVE: To assess the influence of disease activity of patients with rheumatoid arthritis on treatment choices of rheumatologists in countries with restricted access to expensive, innovative drugs. METHODS: Rheumatologists from Hungary, Romania and UK were invited to complete two consecutive discrete choice experiments with hypothetical drug treatments for two different patient profiles: high and moderate disease activity. Rheumatologists were asked to choose repeatedly between two unlabelled treatment options that differed in five attributes: efficacy (expected improvement and achieved disease activity state), safety (probability of serious adverse events), patient's preference (level of agreement), total medication costs and cost-effectiveness. A heteroscedastic discrete choice model using interaction terms between attribute levels and patient profiles (binary variable) was used to assess the preferences of rheumatologists towards each attribute and the influence of the patient profile. RESULTS: Overall, 148 rheumatologists completed the survey (46% females, mean age 49 years, 49% academic). For both patient profiles, efficacy dominated the treatment choice over patient's preference, safety and economic aspects. However, for patients with high compared with moderate disease activity, the importance of drug efficacy significantly increased (from 48% for moderate to 57% for high disease activity), whereas the importance of patient's preference significantly decreased (from 15% to 11%). No significant differences were observed for economic and safety considerations. CONCLUSION: Rheumatologists were willing to give up some efficacy to account for patient's preference when choosing treatments for patients with moderate compared to high disease activity. Disease activity however did not influence importance of economic aspects in treatment choices. BMJ Publishing Group 2017-09-04 /pmc/articles/PMC5588932/ /pubmed/28912960 http://dx.doi.org/10.1136/rmdopen-2017-000453 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Rheumatoid Arthritis
Hifinger, Monika
Hiligsmann, Mickael
Ramiro, Sofia
Watson, Verity
Berghea, Florian
Péntek, Márta
Keat, Andrew
Severens, Johan L
Fautrel, Bruno
Boonen, Annelies
Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists
title Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists
title_full Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists
title_fullStr Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists
title_full_unstemmed Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists
title_short Influence of disease activity on RA treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists
title_sort influence of disease activity on ra treatment choices in countries with restricted access to expensive, innovative drugs: a discrete choice experiment among rheumatologists
topic Rheumatoid Arthritis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588932/
https://www.ncbi.nlm.nih.gov/pubmed/28912960
http://dx.doi.org/10.1136/rmdopen-2017-000453
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