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Patient Preferences Concerning Alternative Treatments for Neuroendocrine Tumors: Results of the “PIANO-Study”

Published online by Cambridge University Press:  02 May 2019

Axel C. Mühlbacher Open the ORCID record for Axel C. Mühlbacher [Opens in a new window]  and
Christin Juhnke
Axel C. Mühlbacher*
Affiliation:
Health Economics and Health Care Management, Hochschule Neubrandenburg, Germany GEB Empirical Consulting mbH, Freiburg, Germany Department of Population Health Sciences, Duke University, Durham, North Carolina
Christin Juhnke
Affiliation:
Health Economics and Health Care Management, Hochschule Neubrandenburg, Germany
*
Author for correspondence: Axel C. Mühlbacher, E-mail: igm@hs-nb.de
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Abstract

Objectives

Neuroendocrine tumors (NETs) are rare, slow-growing malignant tumors. So far, there are no data on patient preferences regarding its therapy. This empirical study aimed to elicit patient preferences in the drug treatment of NET.

Methods

Based on qualitative patient interviews and an analytic hierarchy process, six patient-relevant attributes were analyzed and weighted using a discrete-choice experiment. Patients were recruited with the help of a NET support group. An experimental 3*3 + 6*3 –MNL design was created using NGene. The design consisted of eighty-four choices, divided into seven blocks. Participants were randomly assigned to these blocks. The analysis included random parameter logit and latent class models.

Results

A total of 275 participants (51.6 percent female; mean age, 58.4 years) were included. The preference analysis within the random parameter logit model, taking into account the 95 percent confidence interval, showed predominance for the attribute “overall survival.” The attributes “response to treatment” and “stabilization of tumor growth” followed. The side effects “nausea/vomiting” and “diarrhea” were considered of relatively equal importance. Latent class analysis of possible subgroup differences revealed three preference patterns.

Conclusions

Preferences can influence therapeutic decisions. Preference analyses indicated that “overall survival” had the strongest influence, with participants clearly weighing outcome attributes higher than side effect attributes. In conclusion, mono-criterial decisions would not fully reflect patient perspectives.

Keywords

Patient preferencesDiscrete choice experimentNeuroendocrine tumors
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 3 , 2019 , pp. 243 - 251
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

We thank all participating patients and their families for their support. Our thanks to the support group “Netzwerk Neuroendokrine Tumoren (NeT) e.V.,” in particular Katharina Mellar, for their help in organizing the pretest interviews and recruiting the survey participants. This study was supported by a grant from Ipsen Pharma GmbH.

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