OBJECTIVES: This study assessed the preferences of patients with multiple myeloma (MM) for treatment attributes and evaluated the impact of health-related quality of life (HRQoL) on those preferences.

METHODS: Patients in the UK, France, and Germany with physician-confirmed transplant eligible (TE) or transplant ineligible (TIE) newly diagnosed MM (NDMM) or relapsed/refractory MM (RRMM) completed a discrete choice experiment (DCE). HRQoL was assessed using the EuroQoL Five Dimension (EQ-5D) questionnaire. Preferences for four benefit attributes (increased life expectancy, increased time to relapse, reduced pain, and reduced fatigue), three administration attributes (method of administration, frequency of administration, and monitoring), and one risk attribute (risk of severe infection) were analyzed with a multinominal logit model. Differences between subgroups were also analyzed.

RESULTS: 300 patients completed the DCE (TE NDMM, n=108; TIE NDMM, n=105; RRMM, n=87). Median age was 68 years; most common symptoms were fatigue (69%), bone pain (63%), and sleepiness/tiredness (55%). Median EQ-5D score was 0.8 (IQR 0.7-0.9), with no differences by disease stage. Patients most valued reduced pain and fatigue and increased life expectancy. In general, patients favored shorter injection/monitoring time and less frequent administration. Patients were willing to make trade-offs, such as accepting a reduction of ≥ 2.7 years of life expectancy for no pain vs extreme pain and ≥ 2.0 years for no fatigue vs constant fatigue. Patients with lower EQ-5D scores were willing to trade more years of life expectancy than those with higher scores for reductions in pain or fatigue. Disease stage (NDMM vs RRMM), country, and age did not affect preferences.

CONCLUSIONS: Patients with MM valued treatments that reduced pain and fatigue and were willing to trade life expectancy for better quality of life. HRQoL influenced patient preferences, suggesting that this is an important attribute that should be considered as part of the treatment decision-making process.