Thach A, Coulter J, Leach C, Sutphin J, Mansfield C. On-demand treatment preferences of patients with Parkinson's Disease and “OFF” episodes: heterogeneity across patient subgroups. Poster presented at the MDS Virtual Congress 2020; September 11, 2020. [abstract] Mov Disord. 2020 Sep; 35(S1):S427-8.


OBJECTIVE: To quantify preference heterogeneity for on-demand treatments among patients with Parkinson’s disease (PD) and “OFF” episodes. Background: Patients with PD commonly experience “OFF” episodes. However, little is known about patient preference for different on-demand treatment features and if preferences vary by patient characteristics.

METHODS: Carbidopa/levodopa-treated US adults (age 18–75 years) with self-reported PD for 5 years or <5 years with “OFF” episodes took an online discrete-choice experiment survey. Respondents selected between pairs of experimentally designed profiles for hypothetical on-demand treatments for “OFF” episodes 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 4 random parameters logit subgroup models (Table 1). Statistical significance of preferences between subgroup pairs was determined by χ2 tests.

RESULTS: Overall, preferences were similar across subgroups. However, subgroup model interaction terms for 3 of 4 subgroups tested jointly statistically significantly different (P<0.05; Table 1). While patients with a caregiver did not display a statistically significantly different preference between inhaled medication with AEs and dissolvable sublingual film with AEs (P=0.229) or inhaled medication with AEs and injection with AEs (P=0.09), preferences among patients without a caregiver differed. Similarly, those with on-demand treatment experience did not display a statistically significantly different preference between inhaled medication with AEs and dissolvable sublingual film with AEs (P=0.182) or inhaled medication with AEs and injection with AEs (P=0.376), while preferences differed among patients without on-demand treatment experience. Both patients without a caregiver and those without on-demand treatment experience preferred a sublingual film with AEs to an inhaled medication with AEs, and they also preferred both the sublingual film and inhaled medication to an injected medication with AEs.

CONCLUSIONS: Patients with PD displayed largely homogeneous preferences for the attributes and levels presented in the study, with a few key differences in preferences for mode of administration with associated AEs.

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