OBJECTIVES: Among the bone-targeted agents (BTAs) currently approved for the prevention of skeletal-related events (SREs), several characteristics may be considered by physicians when making treatment decisions. This study evaluated Canadian physicians’ treatment preferences for BTAs used to prevent SREs in patients with bone metastases from solid tumors.  METHODS: Physicians treating patients with bone metastases from solid tumors completed a web-enabled discrete-choice experiment survey consisting of 10 choices between pairs of hypothetical medication profiles for patient with either breast or prostate cancer.  Each hypothetical medication profile included five attributes within a pre-defined range (primarily based on prescribing information): months until first SRE (10, 18 and 28 months); months until worsening of pain (3, 6 and 10 months); annual risk of osteonecrosis of the jaw (ONJ; 0%, 1% and 5%); annual risk of renal impairment (0%, 4% and 10%); and mode of administration (oral tablet, subcutaneous injection, 15-minute infusion and 120-minute infusion). Choice questions were based on an experimental design with known statistical properties. The survey was pretested with 8 physicians using open-ended interviews. A main-effects random parameters logit model was used to analyze the data.  RESULTS: A total of 200 Canadian physicians completed the survey. Over the attribute levels included, months until first SRE, the risk of renal impairment, and months until worsening of pain were the most important attributes. For those attributes, better levels (outcomes) were significantly preferred to worse levels (P < 0.05). For mode of administration, subcutaneous injection was preferred over infusion regardless of duration (P < 0.05).

CONCLUSIONS: When making treatment decisions regarding choice of BTA for patients with bone metastases, delaying the onset of SREs and managing the risk of renal impairment are the primary considerations for Canadian physicians. Also, respondents had well-defined preferences for subcutaneous injections over infusion every 4 weeks.