OBJECTIVES: Inflammatory bowel disease (IBD) is a chronic disease. Currently, several medical biological and small molecule treatments are available for patients with active moderate to severe IBD. To gather more evidence of patient preferences regarding different treatment options, a discrete choice experiment (DCE) is planned. To develop an appropriate DCE design, a preparatory qualitative study was conducted to assess the relevance of different treatment characteristics from the patient’s point of view.

METHODS: A review of Summaries of Product Characteristics and published clinical evidence of respective agents (Vedolizumab, Infliximab, Adalimumab, Golimumab, Ustekinumab and Tofacitinib) was conducted to generate a comprehensive list of potential attributes and respective levels that could characterize these treatments. To verify completeness and applicability, this list was discussed within a steering board (clinical and health-economic experts). In-depth interviews with 28 German focus patients were conducted. A dual-questioning approach (assessment of (1) treatment characteristics and (2) their expressions/distinctness) was used to rank twelve different attributes reflecting short-term and long-term efficacy, safety, time since market approval (TSMA) and mode of administration according to their importance.

RESULTS: 15 patients with Crohn's disease (CD; mean age: 36.1 years; females: 53.3%; mean disease duration: 12.4 years) and 13 with ulcerative colitis (UC; mean age: 33.8 years; females: 61.5%; mean disease duration: 6.9 years) were interviewed. The risk of serious adverse events was ranked to be the most relevant attribute, followed by the risk of non-serious adverse events (UC patients) / skin cancer (CD patients) and remission after one year. In both indications, the time to first symptom relief was less important. TSMA and mode of administration were rated lowest in both groups.

CONCLUSIONS: Generally, safety attributes were identified to be of greatest value for the patients followed by long-term efficacy attributes, while TSMA, administration and short-term efficacy attributes seem to be less relevant.