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PATIENT PRIORITIES FOR TREATMENT ATTRIBUTES IN ADJUNCTIVE DRUG THERAPY OF SEVERE HYPERCHOLESTEROLEMIA IN GERMANY: AN ANALYTIC HIERARCHY PROCESS

Part of: Special Collection - Methods

Published online by Cambridge University Press:  10 July 2018

Axel C. Mühlbacher ,
Anika Kaczynski ,
Franz-Werner Dippel  and
Susanne Bethge
Axel C. Mühlbacher
Affiliation:
Hochschule Neubrandenburg; Gesellschaft für empirische Beratung GmbH (GEB)muehlbacher@hs-nb.de
Anika Kaczynski
Affiliation:
Hochschule Neubrandenburg
Franz-Werner Dippel
Affiliation:
Sanofi Deutschland GmbH, Evidenzbasierte Medizin
Susanne Bethge
Affiliation:
Hochschule Neubrandenburg
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Abstract

Objectives:

Severe hypercholesterolemia is a major cause of death in coronary heart disease. New adjunctive drug therapies have passed authorization processes and been launched recently. So far it is not known which properties of the new treatment options generate the highest benefit for patients. The aim was to evaluate patient priorities in the field of adjunctive drug therapy with apheresis. Therapy characteristics were examined as to their relevance to hypercholesterolemia patients.

Methods:

To identify all potential patient-relevant treatment characteristics, a systematic literature review and ten interviews with patients were conducted. Seven key characteristics were identified from the patient perspective. Patients’ priorities were elicited using an analytic hierarchy process (AHP).

Results:

In total, N = 61 patients diagnosed with severe hypercholesterolemia and undergoing apheresis participated in the study. The analysis showed predominance for the attribute “reduction of LDL-C level in blood” (Wglobal:0.362). The “risk of myopathy” (Wglobal:0.164), “risk of neurocognitive impairment” (Wglobal:0.161) and “frequency of apheresis” (Wglobal:0.119) were ranked second, third and fourth. Subgroup analyses revealed that “frequency of apheresis” is of greater importance to younger patients, men and/or patients who indicated a reduction in quality of life due to apheresis.

Conclusions:

The essential decision criteria for optimal therapy from the patients’ perspective were obtained. “Reduction of lipoprotein in blood” was ranked highest compared with the “mode of administration” and “side effects” characteristics. The study offers a transparent approach for the identification of patient priorities for adjunctive PCSK9-inhibitor therapy in apheresis-treated hypercholesterolemia. The project can be used by healthcare decision makers to understand the importance of each patient-relevant endpoint.

Keywords

Analytic Hierarchy Process (AHP)Patient prioritiesSevere hypercholesterolemiaLipoprotein apheresisAdjunctive drug therapy
Type
Method
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 3 , 2018 , pp. 267 - 275
Copyright
Copyright © Cambridge University Press 2018 

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