Exploring determinants of psoriasis patients' treatment choices: a discrete-choice experiment study in the United States and Germany

Background Biologic psoriasis treatments are differentiated by efficacy, side effects, and other attributes. Objective Determine attributes of biologic psoriasis treatments that drive patients' treatment choices. Methods Respondents (USA: n = 300; Germany: n = 300) with moderate-to-severe psoriasis completed a discrete-choice-experiment survey, choosing between hypothetical treatments characterized by attributes with varying levels: chance of clear skin after 1 year, number of first-year treatments, first-year risks of mild-to-moderate injection site reaction (ISR) and serious infection, and years of proven efficacy/safety. Results U.S. respondents most valued clear skin (conditional relative importance, 1.88; p < .05). While other attributes were of generally equivalent importance, ISR risk outweighed serious-infection risk (1.06 vs. 0.70; p < .05). German respondents placed greatest importance on ISR risk (1.61; p < .05) and clear skin (1.49; p < .05). Limitations Respondents evaluated hypothetical treatments and were recruited from web panels. Conclusions Clear skin and ISR risk are stronger drivers of treatment choice than injection frequency and infection risk.