OBJECTIVES

Current antiviral therapies for chronic hepatitis B (CHB) rarely achieve functional cure, [defined as sustained hepatitis B surface antigen (HBsAg) loss]; thus, lifelong therapy is needed in most patients. A finite therapy achieving functional cure with long-term disease remission could change the treatment landscape substantially. However, it is unknown how patients would evaluate such finite-duration therapy, especially if associated with additional treatment burden.

METHODS

A Discrete Choice Experiment (DCE) was performed between 2018-2019 in Germany. Inclusion criteria of this multicenter study were: CHB diagnosis; age of at least 18 years; no hepatocellular carcinoma; no HIV or HCV/HDV co-infection. The DCE was developed based on qualitative focus-group discussions. The following treatment attributes were included: regimen (tablets; subcutaneous injection+tablets; electroporation (EP)+tablets), side effect frequency (0/1/3 days per month), long-term disease remission (1/30/50% of patients), frequency of physician visits (monthly, half yearly) and travel time to treating physician (15/45 min). Main analysis was done based on a conditional logit model.

RESULTS

130 patients completed the DCE (mean age: 50.2 years, female: 40.0%), 108 with consistent responses based on a test card. Efficacy was found to be the main driver of decisions for/against options (impacted 57% of patients’ decisions) followed by therapy regimen (17%), safety profile (12%) and number of physician visits (11%). Relative utility values were: (1) therapy regimen (reference EP+tablets): tablets 0.430 (p<0.001), subcutaneous monthly injection+tablets 0.060 (p=0.495); (2) efficacy (reference 1%): 30% 0.978 (p<0.001), 50% 1.457 (p<0.001); (3) Side effects (reference 3 days): 1 day 0.182 (p=0.013), 0 days 0.297 (p=0.001); (4) frequency of physician visits (reference monthly): half yearly 0.287 (p<0.001); (5) travel time (reference 45 min): 15 min 0.065 (p=0.237).

CONCLUSIONS

The chance for a long-term disease remission or ‘functional cure’ is deemed more important to patients with CHB, than type of therapy regimen or safety profile.