HOW INDIVIDUALS CHOOSE MEDICATIONS: A DISCRETE CHOICE EXPERIMENT TO UNDERSTAND MANAGEMENT OF EYE ALLERGY RX TO OTC TREATMENT DECISIONS
Author(s)
Leslie Wilson, BS, MS, RN, PhD1, Ruben Vargas III, BA, MPH2;
1UCSF, Professor, San Francisco, CA, USA, 2UCSF, San Francisco, CA, USA
1UCSF, Professor, San Francisco, CA, USA, 2UCSF, San Francisco, CA, USA
OBJECTIVES: Objectives: Allergic conjunctivitis affects nearly 40% of the U.S. population. How individuals choose between OTC and Rx treatments is highly individualized, yet little is known about their decision-making processes. We implemented our choice-based conjoint (CBC) tool to measure preferences for three allergic conjunctivitis treatment approaches: 1) self-selected OTC treatment, 2) pharmacist-advised OTC treatment, and 3) physician-prescribed Rx treatment.
METHODS: Methods: We recruited 1,656 adults from CHPA website and ResearchMatch to take our on-line CBC survey with 7 attributes (Access speed, Accuracy, Administration ease, cost, Relief duration, Side-effects, and First treatment decision). each with 3-4 levels. DCE design was randomized balanced-overlap with 10 choice pairs and 3 fixed scenarios corresponding to each treatment approach. Analysis was random-parameters logistic-regression, sub-analysis, and latent class analysis.
RESULTS: Results: Most respondents were female (73%) and white (79%), but evenly distributed across US region, age groups, marital status, income, education and employment status. Highest preference was for best and better treatment accuracy (β=1.8 & 0.88). Highest negative preferences were for avoiding cost=$50, (β =-1.7), and 40% chance of stinging side effects (β =-1.3), and long waits (β =-0.9); showing willingness to trade high cost and long waits for best accuracy. Importance scores showed cost and accuracy each contributed about 25% to eye treatment decisions, with side-effects 19% and access speed 13%. Latent classes showed heterogeneity with class 1 preferring avoidance of cost and side effects; favoring treatment accuracy and class 2 preferring relief duration and treatment accuracy. Individuals favored OTC selection with pharmacy input.
CONCLUSIONS: Conclusion: We learn how individuals prioritize access and symptom relief when selecting treatment for allergic conjunctivitis, and is a case-study for tools to measure preference for managing minor health decisions. Highest preference for OTC with pharmacy input suggests an emphasis for policymakers to encourage more pharmacist guidance to ensure safe and effective medication selection.
METHODS: Methods: We recruited 1,656 adults from CHPA website and ResearchMatch to take our on-line CBC survey with 7 attributes (Access speed, Accuracy, Administration ease, cost, Relief duration, Side-effects, and First treatment decision). each with 3-4 levels. DCE design was randomized balanced-overlap with 10 choice pairs and 3 fixed scenarios corresponding to each treatment approach. Analysis was random-parameters logistic-regression, sub-analysis, and latent class analysis.
RESULTS: Results: Most respondents were female (73%) and white (79%), but evenly distributed across US region, age groups, marital status, income, education and employment status. Highest preference was for best and better treatment accuracy (β=1.8 & 0.88). Highest negative preferences were for avoiding cost=$50, (β =-1.7), and 40% chance of stinging side effects (β =-1.3), and long waits (β =-0.9); showing willingness to trade high cost and long waits for best accuracy. Importance scores showed cost and accuracy each contributed about 25% to eye treatment decisions, with side-effects 19% and access speed 13%. Latent classes showed heterogeneity with class 1 preferring avoidance of cost and side effects; favoring treatment accuracy and class 2 preferring relief duration and treatment accuracy. Individuals favored OTC selection with pharmacy input.
CONCLUSIONS: Conclusion: We learn how individuals prioritize access and symptom relief when selecting treatment for allergic conjunctivitis, and is a case-study for tools to measure preference for managing minor health decisions. Highest preference for OTC with pharmacy input suggests an emphasis for policymakers to encourage more pharmacist guidance to ensure safe and effective medication selection.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR195
Topic
Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives, Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)