TREATMENT PREFERENCES FOR PHARMACOLOGICAL THERAPIES IN ALZHEIMER'S DISEASE: A SCOPING REVIEW OF STATED-PREFERENCE STUDIES
Author(s)
GaHee Choi, Bachelor's degree1, Yebin Yoon, PharmD2, EUI-KYUNG LEE, PhD1, Mi-Hai Park, PhD1, Ha-Jun Song, PharmD1, Sun-Kyeong Park, PhD2.
1Sungkyunkwan University, Suwon, Korea, Republic of, 2The Catholic University of Korea, Bucheon, Korea, Republic of.
1Sungkyunkwan University, Suwon, Korea, Republic of, 2The Catholic University of Korea, Bucheon, Korea, Republic of.
OBJECTIVES: Alzheimer’s disease (AD) treatments involve complex trade-offs among clinical efficacy, safety, and treatment burden. This scoping review aimed to identify and map stated-preference evidence on treatment attributes and preferences for pharmacological therapies in AD.
METHODS: PubMed and Cochrane Library were searched for stated-preference studies evaluating AD pharmacological or disease-modifying therapy (DMT). Eligible studies used conjoint-based or stated-choice methods and included patients or individuals with cognitive concerns, caregivers, older adults, or clinical stakeholders. Reviews, protocols, non-pharmacological care, and diagnostic preference studies were excluded. Data were charted on study characteristics, respondent population, treatment scenario, elicitation method, attributes, and findings.
RESULTS: Of 400 identified records, four met the inclusion criteria. Respondents comprised general older adults, adults with AD-related risk or mild cognitive concerns, caregivers, and neurologists; no study directly elicited stated-choice preferences from patients with moderate or severe AD. All studies used hypothetical stated-choice tasks; three were discrete choice experiments. Choice contexts ranged from broad DMT concepts and symptom-onset or cognitive-decline delay to a more therapy-specific amyloid plaque-lowering profile. Efficacy was framed as time-related benefits, including delayed onset/progression, longer normal-memory time, and slowed cognitive decline. Safety attributes reflected the treatment concept: broader DMT-oriented studies included severe outcomes such as stroke, death, or permanent disability, whereas the amyloid-targeted profile included ARIA-E/brain swelling, nausea, and treatment-related adverse events. Across studies, delaying progression/onset and serious safety risks were frequently evaluated. Where caregivers and neurologists were compared, both prioritized clinical benefit and ARIA-E risk, while neurologists emphasized administration route and frequency and caregivers were more sensitive to treatment titration.
CONCLUSIONS: Stated-preference evidence for AD pharmacotherapies remains sparse, with substantial variation in treatment contexts, attributes, and respondent groups. Future studies should use therapy-specific treatment profiles and respondent groups that reflect the clinical population and decision context of the therapies being evaluated.
METHODS: PubMed and Cochrane Library were searched for stated-preference studies evaluating AD pharmacological or disease-modifying therapy (DMT). Eligible studies used conjoint-based or stated-choice methods and included patients or individuals with cognitive concerns, caregivers, older adults, or clinical stakeholders. Reviews, protocols, non-pharmacological care, and diagnostic preference studies were excluded. Data were charted on study characteristics, respondent population, treatment scenario, elicitation method, attributes, and findings.
RESULTS: Of 400 identified records, four met the inclusion criteria. Respondents comprised general older adults, adults with AD-related risk or mild cognitive concerns, caregivers, and neurologists; no study directly elicited stated-choice preferences from patients with moderate or severe AD. All studies used hypothetical stated-choice tasks; three were discrete choice experiments. Choice contexts ranged from broad DMT concepts and symptom-onset or cognitive-decline delay to a more therapy-specific amyloid plaque-lowering profile. Efficacy was framed as time-related benefits, including delayed onset/progression, longer normal-memory time, and slowed cognitive decline. Safety attributes reflected the treatment concept: broader DMT-oriented studies included severe outcomes such as stroke, death, or permanent disability, whereas the amyloid-targeted profile included ARIA-E/brain swelling, nausea, and treatment-related adverse events. Across studies, delaying progression/onset and serious safety risks were frequently evaluated. Where caregivers and neurologists were compared, both prioritized clinical benefit and ARIA-E risk, while neurologists emphasized administration route and frequency and caregivers were more sensitive to treatment titration.
CONCLUSIONS: Stated-preference evidence for AD pharmacotherapies remains sparse, with substantial variation in treatment contexts, attributes, and respondent groups. Future studies should use therapy-specific treatment profiles and respondent groups that reflect the clinical population and decision context of the therapies being evaluated.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR176
Topic
Patient-Centered Research
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas