OBJECTIVES:

Immune-mediated inflammatory diseases (IMIDs) represent a high burden due to its chronicity, high prevalence, and associated comorbidities. Chronic patients’ preferences must be considered on IMIDs treatment, and settings regarding the humanistic approach of the treatment are often underestimated. This study objective is to further understand these patient’s preferences in a private setting.

METHODS:

A D-eficient discrete choice experiment (DCE) was designed for eliciting the preferences of patients with IMIDs and potential adalimumab prescription. Participants (n: 87) were collected in private healthcare centers from February-May 2022. Patients chose between 14 choice pairs, characterized by 5 healthcare attributes: access to the specialist through primary care, being treated by a team or by specific physician, choosing the preferred physician, time until test was performed, and time until visit with physician; as well as monthly (mo) out-of-pocket drug price. The resulting data was analyzed according to the random utility theory through a conditional logit model adjusted by patients’ characteristics and the principal outcome was Odds Ratio (OR).

RESULTS:

87 patients answered the questionnaire (64% female; 57±13.49 years). Most patients had higher education (59%) and the most frequent pathologies where Rheumatoid Arthritis (31%), Psoriasic Arthritis (26%), and Ankylosing Spondylitis (18%). The most relevant criteria were choosing the physician of preference (OR: 2.25 95%CI 1.79-2.84); reducing the time until visit with specialist, (OR 1.79 95%CI 1.44-2.24), access through primary care, (OR 0.63 95%CI 0.52- 0.75), and an increase in monthly price from 100€ to 300€ (OR 0.55 95%CI 0.43-0.69), and from 100€ to 600€ (OR 0.08 95%CI 0.05-0.14). Choice 300€/mo out-of-pocket price showed a probability higher of 60%, when service include choosing the physician and rapid direct access to specialist.

CONCLUSIONS:

Chronic IMIDs patients showed a preference towards a fastest, more personalized service, even with a trade-off in terms of 300€/mo out-of-pocket price.