Clinicians' Preferences for Sphingosine-1-Phosphate Receptor Modulators in Multiple Sclerosis Based on Clinical Management Considerations: A Choice Experiment.

Autor: Keenan A; Janssen Scientific Affairs, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA. akeenan1@its.jnj.com., Whichello C; Evidera, The Ark, 201 Talgarth Rd, London, W6 8BJ, UK., Le HH; Janssen Scientific Affairs, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA., Kern DM; Janssen Research and Development, 800 Ridgeview Drive, Horsham, PA, 19044, USA., Fernandez GS; Evidera, 7101 Wisconsin Ave # 1400, Bethesda, MD, 20814, USA., Turner V; Evidera, The Ark, 201 Talgarth Rd, London, W6 8BJ, UK., Das A; Evidera, The Ark, 201 Talgarth Rd, London, W6 8BJ, UK., Quaife M; Evidera, The Ark, 201 Talgarth Rd, London, W6 8BJ, UK., Ross AP; Loyola University Chicago, 2160 S 1st Ave, Maywood, IL, 60153, USA.
Jazyk: angličtina
Zdroj: PharmacoEconomics - open [Pharmacoecon Open] 2024 Nov; Vol. 8 (6), pp. 857-867. Date of Electronic Publication: 2024 Aug 28.
DOI: 10.1007/s41669-024-00510-w
Abstrakt: Background: Four sphingosine-1-phosphate receptor (S1PR) modulators are currently available in the USA for treating relapsing forms of multiple sclerosis (MS). These S1PR modulators have similar efficacy. Clinicians may therefore consider other factors, such as clinical management considerations, when distinguishing among treatments. This study estimated which S1PR modulator clinicians would choose on the basis of a treatment's clinical management and quantified how individual aspects of clinical management might drive this choice.
Methods: A multi-criteria decision analysis (MCDA) was conducted on the basis of clinical management preferences elicited in a discrete choice experiment (DCE) and real-world clinical management profiles of the S1PR modulators currently available to treat relapsing forms of MS (fingolimod, ozanimod, ponesimod, siponimod). The DCE was completed by neurologists in the USA experienced in treating MS and included eight clinical management attributes: first-dose observations, genotyping, liver function tests, eye exams, drug-drug interactions, interactions with antidepressants, interactions with foods high in tyramine, and immune system recovery time. Attribute levels were selected on the basis of S1PR modulator product labels. In the MCDA, partial MCDA scores were created for each attribute and summed to produce an overall MCDA score for each S1PR modulator.
Results: The DCE was completed by 200 neurologists. The overall MCDA score was highest for ponesimod (4.78 points), followed by siponimod (4.10 points), fingolimod (3.61 points), and ozanimod (2.38 points). Having fewer drug-drug interactions contributed most to the overall scores (up to 1.56 points), followed by having no first-dose observations (0.95 points), the shortest immune system recovery time (0.94 points), and not interacting with foods high in tyramine (0.86 points).
Conclusion: When considering clinical management convenience, the average US-based neurologist treating MS is likely to choose ponesimod over siponimod, fingolimod, or ozanimod. The strongest driver of preferences was the number of drug-drug interactions. This information can help inform recommendations for the treatment of MS and facilitate shared decision-making between clinicians and patients.
(© 2024. The Author(s).)
Databáze: MEDLINE
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