Thach A, Sutphin J, Coulter J, Leach C, Pappert E, Mansfield C. Patient preferences for treating “OFF” episodes in parkinson's disease: a discrete choice experiment. Patient Prefer Adherence. 2021 Jun 1;2021(15):1187-96. doi: 10.2147/PPA.S301644.

INTRODUCTION: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

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