Modeling the impact of patient treatment preference on health outcomes in relapsing-remitting multiple sclerosis
| Autor: | Michelle Brauer, Lisa Mucha, Schiffon L Wong, Adeline Durand, Emma van Eijndhoven, Jason Shafrin, Rebecca Kee, Joanna P. MacEwan |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Health outcomes Choice Behavior Drug Administration Schedule Decision Support Techniques 03 medical and health sciences Multiple Sclerosis Relapsing-Remitting 0302 clinical medicine Humans Medicine Patient treatment Practice Patterns Physicians' Intensive care medicine business.industry 030503 health policy & services Health Policy Multiple sclerosis Age Factors Patient Preference Budget impact Middle Aged medicine.disease Markov Chains United Kingdom Preference nervous system diseases Relapsing remitting 030220 oncology & carcinogenesis Disease Progression Female Pregnant Women Quality-Adjusted Life Years 0305 other medical science business Immunosuppressive Agents |
| DOI: | 10.6084/m9.figshare.11512746 |
| Popis: | Aims: Model how moving from current disease-modifying drug (DMD) prescribing patterns for relapsing-remitting multiple sclerosis (RRMS) observed in the United Kingdom (UK) to prescribing patterns based on patient preferences would impact health outcomes over time. Materials and methods: A cohort-based Markov model was used to measure the effect of DMDs on long-term health outcomes for individuals with RRMS. Data from a discrete choice experiment were used to estimate the market shares of DMDs based on patient preferences (i.e. preference shares). These preference shares and real-world UK market shares were used to calculate the effect of prescribing behavior on relapses, disability progression, and quality-adjusted life-years (QALYs). The incremental benefit of patient-centered prescribing over current practices for the UK RRMS population was then estimated; scenario and sensitivity analyses were also conducted. Results: Compared to current prescribing practices, when UK patients with RRMS were treated following patient preferences, health outcomes were improved. This population was expected to experience 501,690 relapses and gain 1,003,263 discounted QALYs over 50 years under patient-centered prescribing practices compared to 538,417 relapses and 958,792 discounted QALYs under current practices (−6.8% and +4.6%, respectively). Additionally, less disability progression was observed when prescribed treatment was based on patient preferences. In a scenario analysis where only oral treatments were considered, the results were similar, although the magnitude of benefit was smaller. Number of relapses was most sensitive to how the annualized relapse rate was modeled; disability progression was most sensitive to mortality rate assumptions. Limitations: Treatment efficacy estimates applied to various models in this study were based on data derived from clinical trials, rather than real-world data; the impact of patient-centered prescribing on treatment adherence and/or switching was not modeled. Conclusions: The population of UK RRMS patients may experience overall health gains if patient preferences are better incorporated into prescribing practices. |
| Databáze: | OpenAIRE |
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