Patient Preferences and Tradeoffs for Therapy-Related Factors of Antivascular Endothelial Growth Factor Agents: A Discrete Choice Experiment
Author(s)
Hanfei WANG, MD1, Jingbo Zhang, master2, Yiwei Li, Bachelor2, Yusi Suo, Bachelor2, Xuejing Jin, PhD3.
1Beijing, China, Beijing university of Chinese medicine, Beijing, China, 2Beijing university of Chinese medicine, Beijing, China, 3Beijing University of Chinese Medicine, Beijing, China.
1Beijing, China, Beijing university of Chinese medicine, Beijing, China, 2Beijing university of Chinese medicine, Beijing, China, 3Beijing University of Chinese Medicine, Beijing, China.
OBJECTIVES: To explore and quantify patient preferences for therapy-related factors of anti-vascular endothelial growth factor agents, and how these preferences impact trade-offs among effectiveness, safety, required injection regimen, and cost.
METHODS: A face-to-face survey was conducted across six Chinese cities from October 2023 to April 2024 among adults with diabetic macular edema (DME) or neovascular age-related macular degeneration (nAMD). Every participant chose between two virtual treatment options in 10 discrete choice experiment tasks, described using six therapy-related attributes: (1) number of injections during loading phase, (2) injection frequency during maintenance phase, (3) retinal edema reduction, (4) visual acuity (VA) improvement, (5) risk of serious adverse events, and (6) cost. Patient preference for each non-omitted attribute level, relative importance of each attribute and trade-offs were calculated using random logit models. A latent class model was used to explore heterogeneity of preferences and trade-offs.
RESULTS: Data of a total 355 participants passed the quality check. All attributes except number of injections during loading phase impacted patient choice. For DME patients (n = 177), injection frequency was the most influential attribute. They were willing to pay an additional $708.60 to extend the injection interval from monthly to treat-and-extend regiment, or accept a 12.97% increased risk, or forgo a 21.76% retinal edema reduction, or a 14.76% VA improvement. For nAMD patients (n = 178), VA improvement was the most important attribute. They were willing to pay $2,329.54 to improve VA from 20% to 43%, or accept a 17.30% increased risk, or forgo an 18.64% reduction in retinal edema, or a 11.88% improvement in VA.
CONCLUSIONS: Ophthalmologists should ensure clear communication of key factors influencing patient choices, capture patient preferences, and provide recommendations that align with individual needs. Further research could explore the balance between existing cost, risk, and potential benefits that patients are willing to accept.
METHODS: A face-to-face survey was conducted across six Chinese cities from October 2023 to April 2024 among adults with diabetic macular edema (DME) or neovascular age-related macular degeneration (nAMD). Every participant chose between two virtual treatment options in 10 discrete choice experiment tasks, described using six therapy-related attributes: (1) number of injections during loading phase, (2) injection frequency during maintenance phase, (3) retinal edema reduction, (4) visual acuity (VA) improvement, (5) risk of serious adverse events, and (6) cost. Patient preference for each non-omitted attribute level, relative importance of each attribute and trade-offs were calculated using random logit models. A latent class model was used to explore heterogeneity of preferences and trade-offs.
RESULTS: Data of a total 355 participants passed the quality check. All attributes except number of injections during loading phase impacted patient choice. For DME patients (n = 177), injection frequency was the most influential attribute. They were willing to pay an additional $708.60 to extend the injection interval from monthly to treat-and-extend regiment, or accept a 12.97% increased risk, or forgo a 21.76% retinal edema reduction, or a 14.76% VA improvement. For nAMD patients (n = 178), VA improvement was the most important attribute. They were willing to pay $2,329.54 to improve VA from 20% to 43%, or accept a 17.30% increased risk, or forgo an 18.64% reduction in retinal edema, or a 11.88% improvement in VA.
CONCLUSIONS: Ophthalmologists should ensure clear communication of key factors influencing patient choices, capture patient preferences, and provide recommendations that align with individual needs. Further research could explore the balance between existing cost, risk, and potential benefits that patients are willing to accept.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR178
Topic
Economic Evaluation, Health Technology Assessment, Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives, Patient Engagement
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)