Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment

Axel C. Mühlbacher, John F P Bridges, Susanne Bethge, Ch M. Dintsios, Anja Schwalm, Andreas Gerber-Grote, Matthias Nübling

Research output: Contribution to journalArticle

Abstract

Background: The German Institute for Quality and Efficiency in Health Care (IQWiG) uses patient-relevant outcomes to inform decision-makers. Objective: IQWiG conducted a pilot study to examine whether discrete choice experiments (DCEs) can be applied in health economic evaluations in Germany to identify, weight, and prioritize multiple patient-relevant outcomes, using the example of antiviral therapy for chronic hepatitis C (HCV). A further objective was to contribute to a more structured approach towards eliciting and comparing preferences across key stakeholders. Methods: In autumn 2010, a DCE questionnaire was sent to patients with chronic HCV to estimate preferences across seven outcomes (“attributes”), including treatment efficacy [sustained viral response (SVR) at 6 months], adverse effects (flu-like symptoms, gastrointestinal symptoms, psychiatric symptoms, and skin symptoms/alopecia), and measures of treatment burden (duration of therapy, frequency of injections). A linear model and an effects coded full model were applied to assess the relative importance of the attributes. Results: In total N = 326 patients were included. A clear preference for SVR was shown; frequency of injections and duration of therapy shared the second rank, while psychiatric symptoms ranked third. The duration of flu-like symptoms was the least important attribute. Conclusion: Our findings indicate that it is possible to perform a DCE at the national level in a health technology assessment agency. The weighting of multiple outcomes allows an indication-specific and evidence-based measure to be used in health economic evaluations. In decision-making in health care, the approach generally allows for consideration of patient-relevant trade-offs regarding the benefits and harms of medical interventions.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalEuropean Journal of Health Economics
DOIs
StateAccepted/In press - Feb 4 2016

Fingerprint

Chronic Hepatitis C
Antiviral Agents
Cost-Benefit Analysis
Psychiatry
Delivery of Health Care
Biomedical Technology Assessment
Injections
Alopecia
Health
Therapeutics
Germany
Linear Models
Decision Making
Weights and Measures
Skin
Hepatitis C
Discrete choice experiment
Therapy

Keywords

  • Conjoint analysis (CA)
  • Discrete choice experiment (DCE)
  • Health technology assessment (HTA)
  • Hepatitis C virus (HCV)
  • Patient preferences
  • Priority setting

ASJC Scopus subject areas

  • Health Policy
  • Economics, Econometrics and Finance (miscellaneous)

Cite this

Mühlbacher, A. C., Bridges, J. F. P., Bethge, S., Dintsios, C. M., Schwalm, A., Gerber-Grote, A., & Nübling, M. (Accepted/In press). Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment. European Journal of Health Economics, 1-11. https://doi.org/10.1007/s10198-016-0763-8

Preferences for antiviral therapy of chronic hepatitis C : a discrete choice experiment. / Mühlbacher, Axel C.; Bridges, John F P; Bethge, Susanne; Dintsios, Ch M.; Schwalm, Anja; Gerber-Grote, Andreas; Nübling, Matthias.

In: European Journal of Health Economics, 04.02.2016, p. 1-11.

Research output: Contribution to journalArticle

Mühlbacher, AC, Bridges, JFP, Bethge, S, Dintsios, CM, Schwalm, A, Gerber-Grote, A & Nübling, M 2016, 'Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment', European Journal of Health Economics, pp. 1-11. https://doi.org/10.1007/s10198-016-0763-8
Mühlbacher, Axel C. ; Bridges, John F P ; Bethge, Susanne ; Dintsios, Ch M. ; Schwalm, Anja ; Gerber-Grote, Andreas ; Nübling, Matthias. / Preferences for antiviral therapy of chronic hepatitis C : a discrete choice experiment. In: European Journal of Health Economics. 2016 ; pp. 1-11.
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