Evolution of High-Efficacy Therapies for Relapsing Multiple Sclerosis: Does Innovation Meet Patient Preferences?
Author(s)
Florian Kuhlmey, PhD1, Michael E. Arzt, PhD2, Marc Bill, MSc1, Lara Diem, Dr. med.3, Barbara Fischer, PhD1, Robert Hoepner, PD4, Pascal A. Rabatscher, PhD2.
1Polynomics AG, Olten, Switzerland, 2Novartis Pharma Schweiz AG, Rotkreuz, Switzerland, 3Kantonsspital Luzern, Luzern, Switzerland, 4Department of Neurology, University Hospital Bern (Inselspital), Bern, Switzerland.
1Polynomics AG, Olten, Switzerland, 2Novartis Pharma Schweiz AG, Rotkreuz, Switzerland, 3Kantonsspital Luzern, Luzern, Switzerland, 4Department of Neurology, University Hospital Bern (Inselspital), Bern, Switzerland.
OBJECTIVES: Several high-efficacy therapies (HET) for relapsing multiple sclerosis (MS) are increasingly used as early treatment options. These therapies differ in their administration profiles. This study estimates preference-based market shares for therapies replicating the evolving administration of HET.
METHODS: We conducted a discrete choice experiment (DCE) in Switzerland with 66 people living with MS (plwMS), as well as 985 people living without MS (plwoMS), approximating the perspective of newly diagnosed plwMS with no prior experience with MS treatments. Preferences for five aspects of HET-administration were elicited: duration, frequency, place and route of administration and need for premedication. Efficacy, safety, and costs were held constant. Based on estimated utility weights, we simulated choice probabilities for treatment profiles reflecting sequential developments in administration.
RESULTS: Duration, frequency and place of administration were the most important aspects of administration in the choice of therapy. To evaluate the impact of developments in the administration of parenteral HETs, we simulated preference-based market shares for five administration profiles. Starting from monthly 1-hour infusions, introducing a 6-monthly 2-hour infusion with premedication was preferred by 55% [CI: 45-65%] of patients. Additionally offering monthly pen-based self-administration at home was chosen by 80% [CI: 64-96%]. Further adding monthly syringe-based injections by a health-care professional was selected by 16% [CI: 7-24%], and a 6-monthly syringe-based injection (requiring premedication) by 25% [CI: 16-34%]. When all five profiles were offered simultaneously, the pen-at-home option remained most preferred (51% [CI: 31-70%]), followed by the syringe-based injections (37% [CI: 22-51%]) and infusions (12% [CI: 4-21%]). A sensitivity analysis revealed similar patterns among plwoMS.
CONCLUSIONS: Pen-at-home is strongly favored by plwMS and plwoMS, even at higher frequency. Objective patient education on therapy options is needed to consider patient preferences in therapy decisions, particularly for newly diagnosed plwMS.
METHODS: We conducted a discrete choice experiment (DCE) in Switzerland with 66 people living with MS (plwMS), as well as 985 people living without MS (plwoMS), approximating the perspective of newly diagnosed plwMS with no prior experience with MS treatments. Preferences for five aspects of HET-administration were elicited: duration, frequency, place and route of administration and need for premedication. Efficacy, safety, and costs were held constant. Based on estimated utility weights, we simulated choice probabilities for treatment profiles reflecting sequential developments in administration.
RESULTS: Duration, frequency and place of administration were the most important aspects of administration in the choice of therapy. To evaluate the impact of developments in the administration of parenteral HETs, we simulated preference-based market shares for five administration profiles. Starting from monthly 1-hour infusions, introducing a 6-monthly 2-hour infusion with premedication was preferred by 55% [CI: 45-65%] of patients. Additionally offering monthly pen-based self-administration at home was chosen by 80% [CI: 64-96%]. Further adding monthly syringe-based injections by a health-care professional was selected by 16% [CI: 7-24%], and a 6-monthly syringe-based injection (requiring premedication) by 25% [CI: 16-34%]. When all five profiles were offered simultaneously, the pen-at-home option remained most preferred (51% [CI: 31-70%]), followed by the syringe-based injections (37% [CI: 22-51%]) and infusions (12% [CI: 4-21%]). A sensitivity analysis revealed similar patterns among plwoMS.
CONCLUSIONS: Pen-at-home is strongly favored by plwMS and plwoMS, even at higher frequency. Objective patient education on therapy options is needed to consider patient preferences in therapy decisions, particularly for newly diagnosed plwMS.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR87
Topic
Methodological & Statistical Research, Patient-Centered Research
Disease
Neurological Disorders