Patient Preferences for Treating “OFF” Episodes in Parkinson’s Disease: A Discrete Choice Experiment

• Published in: Patient preference and adherence Vol. 15; pp. 1187 - 1196
• Main Authors: Thach, Andrew, Sutphin, Jessie, Coulter, Joshua, Leach, Colton, Pappert, Eric, Mansfield, Carol
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: apomorphine sublingual film; discrete choice experiment; Drug dosages; Drug therapy; Human subjects; Medical research; Medicine, Experimental; Original Research; Parkinson's disease; patient preference; Patients; Personal preferences (Social sciences); Polls & surveys; Preferences; Psychological aspects; Qualitative research; “off” episode; United States; United States > US; apomorphine sublingual film; discrete choice experiment; patient preference; “OFF” episode; Parkinson’s disease
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S301644

Several on-demand treatments are available for management of "OFF" episodes in patients with Parkinson's disease (PD). We evaluated patients' preferences for features of theoretical on-demand treatment options. In a discrete choice experiment, US adults with self-reported PD of ≥5 years, or <5 years with "OFF" episodes, taking oral carbidopa/levodopa, selected between pairs of theoretical on-demand treatments that varied by mode of administration (with and without mode-specific adverse events [AEs]), time to FULL "ON," duration of "ON," and out-of-pocket cost for a 30-day supply. Data were analyzed with a random parameters logit model; results were used to calculate relative importance of treatment attributes, preference shares, and willingness to pay. Among 300 respondents, 98% had "OFF" episodes. Across the range of attribute levels included in the survey, avoiding $90 cost was most important to respondents, followed by a preferable mode of administration with associated AEs and decreasing time to FULL "ON." Duration of "ON" was relatively less important. On average, respondents preferred a theoretical dissolvable sublingual film versus other theoretical treatments with alternative modes of administration. Respondents were willing to pay $28-$52 US dollars to switch from least- to more-preferred mode of administration with associated AEs, $58 to reach FULL "ON" in 15 versus 60 min, and $9 to increase duration of FULL "ON" from 1 to 2 h. Respondents with PD valued lower out-of-pocket cost and a sublingual mode of administration with its associated AEs when choosing an on-demand treatment for "OFF" episodes.