BACKGROUND:Oral disease modifying therapies (DMTs) for multiple sclerosis (MS) differ in efficacy, tolerability, and safety.
OBJECTIVE: We sought to understand how these attributes impact patient preference and predicted DMT non-adherence among oral-naïve MS patients.
METHODS:Adult MS patients from the “PatientsLikeMe” Web-based health data-sharing platform completed a discrete choice exercise where they were asked to express their preference for one of three hypothetical oral DMTs, each with a certain combination of levels of tested attributes. Another Web-based exercise tested a number of possible drivers of non-adherence, mainly side effects. Data from an MS clinic were used to adjust for sample bias. Respondents’ preferences were analyzed using Hierarchical Bayesian estimation.
RESULTS:A total of 319 patients completed all questions. Most respondents were female (77.7%, 248/319) with mean age 48 years (SD 10). Liver toxicity was the attribute that emerged as the most important driver of patient preference (25.8%, relative importance out of 100%), followed by severe side effects (15.3%), delay to disability progression (10.7%), and common side effects (10.4%). The most important drivers of predicted non-adherence were frequency of daily dosing (17.4% out of 100%), hair thinning (14.8%), use during pregnancy (14.1%), severe side effects (13.8%), and diarrhea (13.0%).
CONCLUSIONS:Understanding the important concerns expressed by patients may help health care providers to understand and educate their patients more completely about these concerns. This knowledge may therefore improve both choices of appropriate therapy and adherence to therapy over time.
This is a survey on what you want from your pills. So if you look at which pills you prefer obviously you want them to work and then there is an issue of side effects. It they have nasty side effects you won’t want them, So if its hair thinning we know which pill you are worried about (Aubagio), pregnancy, you may not want some (Aubagio) because of birth defect potential, gut problems (Tecfidera) don’t want to take it too often (Tecfidera). I guess it’s not rocket science but Pharma do spend alot on Marketing so your choice…is their profit.