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

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

Research output: Contribution to journalArticlepeer-review

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)155-165
Number of pages11
JournalEuropean Journal of Health Economics
Volume18
Issue number2
DOIs
StatePublished - Mar 1 2017

Keywords

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

ASJC Scopus subject areas

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

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