Assessment of Relative Importance of Disease Modifying Treatment (DMT) Attributes in Multiple Sclerosis (MS) Patients

Objective: To provide information on different DMT attributes’ relative importance for MS patients. Background: DMT’s vary in efficacy, side effect profile, route of administration and monitoring requirements. Understanding patients’ needs and wishes regarding DMT is important since patient satisfaction with choice of treatment impacts adherence and patient management. Design/Methods: Discrete choice experiment (DCE) including the following attributes: reduction in risk of relapse (RRR), reduction in risk of disease progression, adverse event profiles (AEs), route of administration, number of blood samples per year and possibility of treatment during pregnancy. Attributes originated from summary of product characteristics (SPC) of four DMTs. MS experts evaluated the DCE questionnaire. Patients were included through an unpaid online campaign. Results: 218 respondents completed the questionnaire. 82% of respondents were female. Average age was 42 years and disease duration 7.3 years. Relative preferences for the attributes of DMTs were calculated into the same scale for comparability i.e. reduction in relapse rate (RRR). The relative value of each categorical attribute (adverse events, route of administration, blood samples, pregnancy) was translated to an incremental increase in RRR relative to avoiding the least preferred option. RRR was: 93% for daclizumab, 84% for peg-interferon, 78 % for dimethyl fumarate and 51% for teriflunomide. Main drivers of patient preferences were efficacy on RRR, reduction in disease progression and AE profile. Generally, patients prefer oral treatment, although once monthly subcutaneously injection equaled twice daily oral treatment. Frequent blood sampling could outweigh the benefit of an oral treatment. Conclusions: We used DCE to compare DMTs based on the SPC. The model makes it possible to objectively compare patient preferences regarding DMTs and could be a useful tool in the development of treatment guidelines. Study Supported by: This study was funded by grants from Biogen. Disclosure: Dr. Sejbaek has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen, Genzyme, Merck, Novartis, Teva. Dr. Bogelund has nothing to disclose. Dr. Leander has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen. Dr. Leander holds stock and/or stock options in Biogen, which sponsored research in which Dr. Leander was involved as an investigator. Dr. Leander holds stock and/or stock options in Biogen. Dr. Madsen has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen. Dr. Madsen holds stock and/or stock options in Biogen, which sponsored research in which Dr. Madsen was involved as an investigator. Dr. Madsen holds stock and/or stock options in Biogen.