EVALUATING PATIENT PREFERENCES FOR COPD MAINTENANCE TREATMENT DELIVERY DEVICES: A DISCRETE CHOICE EXPERIMENT
Author(s)
Suzanne McMullen, MHA1, Michael Hess, MPH2, Alexis T. Mickle, MSc1, Grace Leung, MPH3, Joseph Cook, JD, PhD4, Misty Green, MSc2, Mark Luttmann, BSc2, Karissa M. Johnston, PhD1, Sarah Walker, MSc.1, Bruce Miller, PhD2;
1Broadstreet HEOR, Vancouver, BC, Canada, 2COPD Foundation, Miami, FL, USA, 3Theravance Biopharma US, San Francisco, CA, USA, 4Viatris Inc, Mamaroneck, NY, USA
1Broadstreet HEOR, Vancouver, BC, Canada, 2COPD Foundation, Miami, FL, USA, 3Theravance Biopharma US, San Francisco, CA, USA, 4Viatris Inc, Mamaroneck, NY, USA
OBJECTIVES: This study evaluated patient preferences for attributes of chronic obstructive pulmonary disease (COPD) treatment devices via a discrete choice experiment (DCE).
METHODS: A DCE was conducted among adults living in the United States with self-reported COPD for ≥2 years and experience using inhaled and nebulized COPD maintenance medications outside a hospital setting. Six attributes selected based on qualitative interviews and literature, described device features including: effectiveness; portability; eco-friendliness; out-of-pocket (OOP) cost; administration time (including cleaning/care); and dose frequency. Participants who failed logic/engagement checks (one-sided or dominance tests) were removed from the analytic dataset. Relative attribute importance was calculated in percentages using attribute-based normalization; preferences were analyzed using conditional logistic regression and presented as odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: The analytic dataset included 269 people with a mean (standard deviation) age of 63 (15) years; 43% were women. Effectiveness (28%) and cost (24%) were found to be most important in hypothetical treatment decision making. Portability (15%), eco-friendliness (14%), and dose frequency (13%) were of moderate importance; administration time (6%) ranked lowest. Participants had 1.82 (95% CI: 1.59-2.09; p<0.001) and 3.65 (CI: 3.00-4.44; p<0.001) times the odds of choosing a device that delivered medication with moderate or high versus low effectiveness, respectively. Compared with a treatment with $300/month OOP costs, participants had 1.56 (CI: 1.34-1.83; p=0.001), 2.17 (CI: 1.80-2.62; p<0.001), or 2.09 (CI: 1.72-2.54; p<0.001) times the odds of choosing a device with monthly OOP costs of $50, $25, or $0, respectively.
CONCLUSIONS: In this study, respondents’ device preferences were driven most strongly by clinical benefit and OOP cost, while administration time ranked as least important. Preferences for treatments with $0 versus $25 monthly OOP costs were similar, suggesting minimal sensitivity within this lower cost range. These findings can help COPD clinicians and their patients choose treatments aligned with patient preferences.
METHODS: A DCE was conducted among adults living in the United States with self-reported COPD for ≥2 years and experience using inhaled and nebulized COPD maintenance medications outside a hospital setting. Six attributes selected based on qualitative interviews and literature, described device features including: effectiveness; portability; eco-friendliness; out-of-pocket (OOP) cost; administration time (including cleaning/care); and dose frequency. Participants who failed logic/engagement checks (one-sided or dominance tests) were removed from the analytic dataset. Relative attribute importance was calculated in percentages using attribute-based normalization; preferences were analyzed using conditional logistic regression and presented as odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: The analytic dataset included 269 people with a mean (standard deviation) age of 63 (15) years; 43% were women. Effectiveness (28%) and cost (24%) were found to be most important in hypothetical treatment decision making. Portability (15%), eco-friendliness (14%), and dose frequency (13%) were of moderate importance; administration time (6%) ranked lowest. Participants had 1.82 (95% CI: 1.59-2.09; p<0.001) and 3.65 (CI: 3.00-4.44; p<0.001) times the odds of choosing a device that delivered medication with moderate or high versus low effectiveness, respectively. Compared with a treatment with $300/month OOP costs, participants had 1.56 (CI: 1.34-1.83; p=0.001), 2.17 (CI: 1.80-2.62; p<0.001), or 2.09 (CI: 1.72-2.54; p<0.001) times the odds of choosing a device with monthly OOP costs of $50, $25, or $0, respectively.
CONCLUSIONS: In this study, respondents’ device preferences were driven most strongly by clinical benefit and OOP cost, while administration time ranked as least important. Preferences for treatments with $0 versus $25 monthly OOP costs were similar, suggesting minimal sensitivity within this lower cost range. These findings can help COPD clinicians and their patients choose treatments aligned with patient preferences.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PT35
Topic
Patient-Centered Research
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)