Presentation (CTI)

OBJECTIVES: It is challenging to determine the relevance of specific patient sub-populations when planning how to position a novel treatment entering into a well-established category. Understanding the key patient characteristics that will impact decision-making between different options when physicians make their treatment decisions is essential for identifying sub-populations of interest to help define strategies for both health-technology assessments (HTA), and effective marketing and communications.
METHODS: An underutilised methodology, Situational Choice Experiment (SCE), was used in this study to model hypothetical physician prescribing decisions for treatments for stroke prevention in patients with non-valvular atrial fibrillation (SPAF). To achieve this, we examined the likelihood of selecting different treatment options, including a novel therapy with an improved safety profile relative to the existing standard-of-care direct oral anticoagulants (DOACs), which was assumed to be available in scenarios evaluating diverse patient profiles. This approach addresses the unmet needs of predicting the adoption of new treatments within this established-treatment category and providing evidence to inform HTA submissions.
RESULTS: An SCE was conducted with 250 physicians across primary and secondary care, including cardiologists, stroke physicians, haematologists, general practitioners. Physicians evaluated hypothetical patient profiles varying in characteristics such as age, comorbidities, and bleeding history. Results revealed that bleeding history was the most influential factor driving preference for the novel therapy over DOACs, particularly in high-risk patients. Treatment choice is split between existing DOAC and the novel therapy for patients with a low bleeding risk but other complications (high number of comorbidities, advanced age). The SCE simulator further demonstrated how changes in patient characteristics influenced treatment preferences, providing insights into the potential positioning of the novel therapy in SPAF management.
CONCLUSIONS: This study highlights the utility of SCEs in capturing physician decision-making processes, offering a robust and nuanced framework for predicting treatment adoption and informing clinical, HTA, and marketing strategies for novel therapies.