OBJECTIVES: The availability of direct acting antivirals (DAA), showing consistently high sustained virologic response (SVR) rates and low side effects, has led to a paradigm shift in the treatment of chronic hepatitis C virus (HCV) infection. The objective of this research was to gain understanding into the factors currently driving physician preferences for HCV treatment in Portugal.

METHODS: An adaptive conjoint analysis was conducted, through a web survey, to elicit treatment preferences from a panel of national experts (gastroenterology, infectious disease and internal medicine specialists). Seven treatment attributes were considered, with between 2 and 4 attribute levels each: SVR rate, safety/tolerability profile, daily pill burden, treatment duration, availability of subsequent therapy options, level of drug-drug interactions (DDI), and real-world data (RWD) availability.

RESULTS: Among the seven treatment attributes, level of DDI was considered the most important one, with an average relative importance of 20.80% [95% CI: 17.24-24.35]. At 8,86% [95% CI: 4.16-13.55%] and 7,69% [95% CI: 4.90-10.47%], SVR rate and daily pill burden, respectively, were the least important attributes. Besides level of DDI, safety/tolerability profile (18.40% [95% CI: 15.13-21.67%]) and treatment duration (17.28% [95% CI: 12.73-21.83%]) also obtained a high relative importance. Level partworths indicated that low DDI levels are highly preferred to high DDI levels, and somewhat to moderate DDI levels. Similarly, 8-week regimens are highly preferred to 16 and 24-week regimens, but only marginally to 12-week regimens. Results on RWD availability indicated that its importance is related mainly to the robustness of the data rather than its existence.

CONCLUSIONS: This research confirms the paradigm shift in the management of HCV infection, recognizing the importance of factors other than SVR rates in physicians’ current preferences for HCV treatment.