Development of a Discrete Choice Experiment Survey to Assess Patient Preferences for Treatment of Metastatic Breast Cancer
Author(s)
David Chandiwana, MSc1, Chloe Grace Rose, MS, PharmD2, Darrin Benjumea, MPH3, Joshua Coulter, MA2, Nicole Schroeder, MPH, MBA1, Caroline Vass, PhD4, Cooper Bussberg, BA5, Suzana Karim, PhD5, Verity Watson, PhD4, Michelle Edwards, PharmD1.
1Arvinas Operations, Inc., New Haven, CT, USA, 2Pfizer, Inc., New York, NY, USA, 3Genesis Research Group, Hoboken, NJ, USA, 4RTI Health Solutions, Manchester, United Kingdom, 5RTI Health Solutions, Research Triangle Park, NC, USA.
1Arvinas Operations, Inc., New Haven, CT, USA, 2Pfizer, Inc., New York, NY, USA, 3Genesis Research Group, Hoboken, NJ, USA, 4RTI Health Solutions, Manchester, United Kingdom, 5RTI Health Solutions, Research Triangle Park, NC, USA.
OBJECTIVES: Understanding patient preferences for metastatic breast cancer (MBC) treatments is essential for supporting shared decision-making, which may improve adherence and patient outcomes. Here, we report findings from pretest patient interviews evaluating interpretability and relevance of a discrete choice experiment (DCE) survey developed to assess treatment preferences among patients previously treated for estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) MBC.
METHODS: A DCE survey was developed where patients review and respond to choice questions designed to test trade-offs they are willing to make between different attributes of MBC treatments, including efficacy (progression-free survival [PFS]), risks of adverse events (hyperglycemia, gastrointestinal symptoms, rash, mouth sores), mode of administration (oral, injection, both), and dosing frequency (daily, twice daily, monthly). To test the survey design, a pretest was conducted; 15 adult patients with confirmed ER+/HER2- MBC diagnosis and previous treatment with ≤2 lines of therapy for MBC participated in semi-structured, individual interviews. Patients reacted to draft questions and discussed their current treatment journey, sharing insights on choice-question comprehension and prioritization of various treatment attributes.
RESULTS: All 15 patients had previously received ≥1 therapy for MBC (oral: n=15; injectable: n=12) and were actively receiving treatment (majority CDK4/6 inhibitor, n=12). Patients reported that the survey clearly communicated treatment attributes, with minor refinements suggested and implemented. Attributes and their assigned levels were perceived by the patients as relevant to their cancer treatment, and their experiences and/or expectations. While initial insights suggest PFS is the most important attribute in treatment decision-making, when differences in PFS are minimal, other attributes were considered.
CONCLUSIONS: Findings support the relevance of the DCE survey for capturing patient treatment preferences in MBC and affirm the structure of our larger DCE study and patient willingness to engage in discussions of treatment attributes and trade-offs. The larger DCE study will be initiated in late 2025.
METHODS: A DCE survey was developed where patients review and respond to choice questions designed to test trade-offs they are willing to make between different attributes of MBC treatments, including efficacy (progression-free survival [PFS]), risks of adverse events (hyperglycemia, gastrointestinal symptoms, rash, mouth sores), mode of administration (oral, injection, both), and dosing frequency (daily, twice daily, monthly). To test the survey design, a pretest was conducted; 15 adult patients with confirmed ER+/HER2- MBC diagnosis and previous treatment with ≤2 lines of therapy for MBC participated in semi-structured, individual interviews. Patients reacted to draft questions and discussed their current treatment journey, sharing insights on choice-question comprehension and prioritization of various treatment attributes.
RESULTS: All 15 patients had previously received ≥1 therapy for MBC (oral: n=15; injectable: n=12) and were actively receiving treatment (majority CDK4/6 inhibitor, n=12). Patients reported that the survey clearly communicated treatment attributes, with minor refinements suggested and implemented. Attributes and their assigned levels were perceived by the patients as relevant to their cancer treatment, and their experiences and/or expectations. While initial insights suggest PFS is the most important attribute in treatment decision-making, when differences in PFS are minimal, other attributes were considered.
CONCLUSIONS: Findings support the relevance of the DCE survey for capturing patient treatment preferences in MBC and affirm the structure of our larger DCE study and patient willingness to engage in discussions of treatment attributes and trade-offs. The larger DCE study will be initiated in late 2025.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR59
Topic
Patient-Centered Research
Disease
Oncology, Personalized & Precision Medicine