Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment

Axel C. Mühlbacher (), John F. P. Bridges, Susanne Bethge, Ch.-Markos Dintsios, Anja Schwalm, Andreas Gerber-Grote and Matthias Nübling
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Axel C. Mühlbacher: University of Applied Sciences Neubrandenburg
John F. P. Bridges: Johns Hopkins Bloomberg School of Public Health
Susanne Bethge: University of Applied Sciences Neubrandenburg
Ch.-Markos Dintsios: Bayer Health Care
Anja Schwalm: Institute for Quality and Efficiency in Health Care (IQWiG)
Andreas Gerber-Grote: Institute for Quality and Efficiency in Health Care (IQWiG)
Matthias Nübling: Empirical Consulting mbH (GEB mbH)

The European Journal of Health Economics, 2017, vol. 18, issue 2, No 3, 155-165

Abstract: Abstract Background The German Institute for Quality and Efficiency in Health Care (IQWiG) uses patient-relevant outcomes to inform decision-makers. Objective IQWiG conducted a pilot study to examine whether discrete choice experiments (DCEs) can be applied in health economic evaluations in Germany to identify, weight, and prioritize multiple patient-relevant outcomes, using the example of antiviral therapy for chronic hepatitis C (HCV). A further objective was to contribute to a more structured approach towards eliciting and comparing preferences across key stakeholders. Methods In autumn 2010, a DCE questionnaire was sent to patients with chronic HCV to estimate preferences across seven outcomes (“attributes”), including treatment efficacy [sustained viral response (SVR) at 6 months], adverse effects (flu-like symptoms, gastrointestinal symptoms, psychiatric symptoms, and skin symptoms/alopecia), and measures of treatment burden (duration of therapy, frequency of injections). A linear model and an effects coded full model were applied to assess the relative importance of the attributes. Results In total N = 326 patients were included. A clear preference for SVR was shown; frequency of injections and duration of therapy shared the second rank, while psychiatric symptoms ranked third. The duration of flu-like symptoms was the least important attribute. Conclusion Our findings indicate that it is possible to perform a DCE at the national level in a health technology assessment agency. The weighting of multiple outcomes allows an indication-specific and evidence-based measure to be used in health economic evaluations. In decision-making in health care, the approach generally allows for consideration of patient-relevant trade-offs regarding the benefits and harms of medical interventions.

Keywords: Discrete choice experiment (DCE); Conjoint analysis (CA); Hepatitis C virus (HCV); Health technology assessment (HTA); Patient preferences; Priority setting (search for similar items in EconPapers)
JEL-codes: H I (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (5)

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DOI: 10.1007/s10198-016-0763-8

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