OBJECTIVES: Neovascular age-related macular degeneration (nAMD) is one of the leading causes of vision loss in people older than 65 years. Its treatment with vascular endothelial growth factor (VEGF) inhibitors is associated with high use of healthcare resources and a significant burden on patients/caregivers and physicians. Exploring different stakeholders’ preferences is crucial to understanding disease management. Therefore, this study aims to elicit the preferences for the characteristics of nAMD management and anti-VEGF treatment from patients’ and ophthalmologists’ perspectives.

METHODS: A discrete choice experiment (DCE) was conducted. During the DCE participants choose between two hypothetical treatments that result from combining 5 attributes (effects on visual function, effects on retinal fluid, treatment regimen, monitoring frequency, and cost) with its levels (4 attributes of 3 levels and 1 attribute of 2 levels). The attributes and levels were identified through a review of the literature and 2 focus groups (patients=4; experts=6). The relative importance (RI) given to each attribute was estimated using a mixed logit model. The marginal rates of substitution (MRS) were calculated taking cost as the risk attribute.

RESULTS: A total of 110 patients [79.0 (SD:7.4) years; 57.3% women; 2.3 (SD:0.7) years with nAMD; 2.1 years (SD:0.1) in treatment] and 70 ophthalmologists participated in the study. Patients and ophthalmologists gave greater RI to improvements on visual function (patient: 60.0%; ophthalmologist: 52.7%), less monitoring frequency (patient: 20.2%; ophthalmologist: 27.1%), and reduction on retinal fluid (patient: 9.8%; ophthalmologist: 13.0%). Regarding to MRS, ophthalmologists were willing to increase the cost by 56.5% in exchange for improving visual function (patient: 65.0%) and 43.3% for delaying the monitoring frequency by one month (patient: 25.5%).

CONCLUSIONS: Patients’ and ophthalmologists’ preferences for nAMD treatment were mainly determined by treatment capacity to improve visual function. Ophthalmologists also consider the monitoring frequency during treatment election.