OBJECTIVES: With new single-inhaler triple therapies available for treatment of COPD, patient preferences can be used to inform treatment decisions. This study elicited patient preferences for different attributes of COPD treatments using a discrete choice experiment (DCE) in the UK, Germany and USA. This abstract presents results from Germany only.

METHODS: Following qualitative research in patients with COPD, attributes describing features of COPD maintenance treatments were identified: ease of inhaler use, number of exacerbations in the next year, daily frequency of inhaler use, number of different inhalers used, out-of-pocket costs, and side-effects. The online DCE survey comprised 18 choice sets with logical (dominant) choice and consistency checks, along with demographic and disease history questions. Cognitive debriefing interviews and a pilot study confirmed survey feasibility. The final DCE survey was completed by 150 patients with moderate/severe COPD in Germany. DCE data were analysed using mixed-effect logit models.

RESULTS: The logical choice check was answered correctly by 146 (97%) participants, who were included in the final models; 112 (75%) selected the same choice within the consistency check. Patients placed most value on a treatment with fewer side effects (OR 5.14 [95% CI: 4.40-6.01] “no side effects” vs. “a lot of side effects”), fewer exacerbations (1.82 [1.69-1.97] per exacerbation per year), and which are easier to use (1.33 [1.16-1.51] “no mistakes” vs. “a lot of mistakes”). Patients also preferred treatments with fewer inhalers (1.17 [1.09-1.25] per inhaler reduction), taken less frequently (1.10 [1.02-1.17] per reduction in daily-dose), and were likely to choose a cheaper option (1.16 [1.07-1.25] per 5% decrease in cost).

CONCLUSIONS: In principle, patients in Germany with COPD place most importance on the avoidance of side effects and reduction of symptoms when choosing a treatment. However, ease and frequency of use, inhaler number, and cost were also important drivers of choice.