OBJECTIVES: New allergy desensitization treatments being developed offer the potential for reductions in risk of severe allergic reactions to accidental peanut exposures. This study aimed to quantify treatment features and decision-maker characteristics that influence stated preferences for desensitization treatment among caregivers of peanut-allergic children in the United States.

METHODS: A national sample of 500 parents completed an online discrete-choice-experiment survey. Respondents evaluated a series of two hypothetical treatment profiles alongside a no-treatment option. Treatment profiles varied in mode of administration, peanut tolerance level, proportion discontinuing treatment due to side effects, and cost. A probit model estimated probability of choosing treatment at least once out of 12 questions, as compared to never choosing treatment. A latent-class model estimated relative-importance weights for treatment features.

RESULTS: Approximately 90% chose treatment at least once. Fathers, non-Asians, and younger parents were more likely to choose treatment at least once. Meanwhile, those who reported 100% chance of being able to manage an allergic reaction, those who perceived capsule as ‘very inconvenient’, and those who reported cost as being most important were more likely never to choose treatment.

Among the 90% who chose treatment at least once, latent-class analysis identified 3 classes, representing 41%, 33%, and 27% of the sample, respectively. If offered a treatment with the mean value for efficacy, side effects, and cost, the model predicted that 8%, 70%, and 4% would choose treatment for each class, respectively. If offered the best efficacy, no side effects, and lowest cost, the model predicted that 2/3, all, and about half would choose treatment, respectively.

CONCLUSIONS: Factors affecting likelihood to select peanut-allergy desensitization treatment were heterogeneous among caregivers participating in a choice-experiment study. Understanding the factors affecting likelihood to start desensitization treatment will be important for shared decision making between clinicians and caregivers.