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Arellano J, González JM, Qian Y, Habib M, Mohamed AF, Gatta F, Hauber AB, Posner J, Califaretti N, Chow E. Physician preferences for bone metastasis drug therapy in Canada. ACTA ACUST UNITED AC 2015; 22:e342-8. [PMID: 26628874 DOI: 10.3747/co.22.2380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Currently in Canada, several bone-targeted agents (btas) with varying characteristics are available for the prevention of skeletal-related events (sres) in patients with bone metastasis secondary to solid tumours. In the present study, we evaluated the preferences of physicians in Canada for the various attributes of the available btas. METHODS Physicians treating patients with bone metastasis from solid tumours were invited to complete an online discrete-choice experiment. Respondents were asked to choose between pairs of hypothetical medications for virtual patients. Each hypothetical medication was described based on predefined key attributes: time until first sre, time until worsening of pain, medication-related annual risk of osteonecrosis of the jaw (onj), medication-related annual risk of renal impairment, and mode of administration. A random-parameters logit model was used to analyze the choices between hypothetical medications and thus infer physician preferences for medication attributes. RESULTS Responses from the 200 physicians who completed the discrete-choice experiment suggested that months until first sre, risk of renal impairment, and months until worsening of pain were considered the most important attributes affecting choice of bta. The annual risk of onj was considered the least important attribute. CONCLUSIONS When making treatment decisions about the choice of bta for patients with bone metastasis from solid tumours, delaying sres and worsening of pain, and reducing the risk of renal impairment are primary considerations for physicians in Canada.
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Affiliation(s)
| | - J M González
- RTI Health Solutions, Research Triangle Park, NC, U.S.A
| | - Y Qian
- Amgen, Thousand Oaks, CA, U.S.A
| | | | | | - F Gatta
- Amgen Europe, Zug, Switzerland
| | | | | | | | - E Chow
- Sunnybrook Health Sciences Centre, Toronto, ON
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González JM, Gatta F, Arellano J, Qian Y, Ertugrul G, Hauber AB, Posner J, Oksuzoglu B. Physicians' Preferences for Bone Metastases Treatments in Turkey. Value Health 2014; 17:A570. [PMID: 27201902 DOI: 10.1016/j.jval.2014.08.1905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- J M González
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - F Gatta
- Amgen (Europe) GmbH, Zug, Switzerland
| | | | - Y Qian
- Amgen Inc., Thousand Oaks, CA, USA
| | | | - A B Hauber
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - J Posner
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - B Oksuzoglu
- Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Broekhuizen H, IJzerman MJ, Hauber AB, Groothuis-Oudshoorn CGM. Patient Preferences And Hiv Drugs: What About Uncertainty? Value Health 2014; 17:A565. [PMID: 27201874 DOI: 10.1016/j.jval.2014.08.1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - M J IJzerman
- University of Twente and MIRA institute for Biomedical Technology & Technical Medicine, Enschede, The Netherlands
| | - A B Hauber
- RTI Health Solutions, Research Triangle Park, NC, USA
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Gatta F, Qian Y, Ertugrul G, Hauber AB, Gonzalez JM, Posner J, Oksuzoglu B, Arellano J. Patients' Preferences for Bone Metastases Treatments in Turkey. Value Health 2014; 17:A648. [PMID: 27202336 DOI: 10.1016/j.jval.2014.08.2353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- F Gatta
- Amgen (Europe) GmbH, Zug, Switzerland
| | - Y Qian
- Amgen Inc., Thousand Oaks, CA, USA
| | | | - A B Hauber
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - J M Gonzalez
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - J Posner
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - B Oksuzoglu
- Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Hauber AB, Standaert B, Poulos C. Development of a Survey to Quantify Parents' Priorities for Vaccinating Children Against Rotavirus. Value Health 2014; 17:A681. [PMID: 27202517 DOI: 10.1016/j.jval.2014.08.2541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A B Hauber
- RTI Health Solutions, Research Triangle Park, NC, USA
| | | | - C Poulos
- RTI Health Solutions, Research Triangle Park, NC, USA
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Hauber AB, Arden NK, Mohamed AF, Johnson FR, Peloso PM, Watson DJ, Mavros P, Gammaitoni A, Sen SS, Taylor SD. A discrete-choice experiment of United Kingdom patients' willingness to risk adverse events for improved function and pain control in osteoarthritis. Osteoarthritis Cartilage 2013. [PMID: 23182815 DOI: 10.1016/j.joca.2012.11.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess patient preferences for treatment-related benefits and risks associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA). DESIGN Using a chronic-illness panel in the United Kingdom, patients 45 years or older with a self-reported diagnosis of OA were eligible to participate in the study. Patient preferences were assessed using a discrete-choice experiment that compared hypothetical treatment profiles of benefits and risks consistent with NSAID use. Benefit outcomes (ambulatory pain, resting pain, stiffness, and difficulty doing daily activities) were presented on a 0-to-100 mm scale. Risk outcomes (bleeding ulcer, stroke, and myocardial infarction [MI]) were expressed as probabilities over a fixed time period. Each patient answered 10 choice tasks comparing different treatment profiles. Preference weights were estimated using a random-parameters logit model. RESULTS Final sample included 294 patients. Patients ranked reductions in ambulatory pain and difficulty doing daily activities (both: 6.32; 95% confidence interval [CI]: 5.0-7.6) as the most important benefit outcomes, followed by reductions in resting pain (2.80; 95% CI: 1.8-3.8) and stiffness (2.65; 95% CI: 0.9-4.4). Incremental changes (3%) in the risk of MI or stroke were assessed as the most important risk outcomes (10.00; 95% CI: 8.2-11.8; and 8.90; 95% CI: 7.3-10.5, respectively). CONCLUSION Patients ranked ambulatory pain as a more important benefit than resting pain; likely due to its impact on ability to do daily activities. For a 25-mm reduction, patients were willing to accept four times the risk of MI in ambulatory pain vs resting pain.
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Affiliation(s)
- A B Hauber
- Health Preference Assessment, RTI Health Solutions, Research Triangle Park, NC 27709-2194, USA.
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Hauber AB, Mohamed AF, Johnson FR, Neary M. Patient preferences for targeted agents in renal cell carcinoma (RCC): A benefit–risk conjoint study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
AIMS Medication non-adherence is particularly common in patients with Type 2 diabetes. We constructed a discrete-choice experiment to examine the relative importance of oral glucose-lowering medication features and to estimate the likely effect of effectiveness and side effects on medication adherence in patients with Type 2 diabetes in the UK and the USA. METHODS Preferences were elicited using a cross-sectional, web-enabled survey. Patients with a self-reported physician-made diagnosis of Type 2 diabetes, who were currently taking oral glucose-lowering medications were recruited through an existing online chronic-disease panel. In each discrete-choice question, patients were asked to choose between two hypothetical medication alternatives, each defined by improvement in glycated haemoglobin, frequency of mild-to-moderate hypoglycaemia, water retention, weight gain, mild stomach upset and medication-related cardiovascular risk. Patients were also asked to indicate how likely they would be to miss or skip doses of each hypothetical medication. RESULTS Two hundred and four patients in the UK and 203 patients in the USA completed the survey. Preferences did not differ between the two countries. Overall, glucose control was the most important medication feature, followed by medication-related cardiovascular risk and weight gain, respectively. Water retention was not important to patients. Weight gain and cardiovascular risk had significant negative effects on likely medication adherence. CONCLUSIONS While patients with Type 2 diabetes believe glucose control is important, medication side effects and risks influence patients' treatment choices. Medication-related weight gain and cardiovascular risk are significant predictors of likely medication non-adherence.
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Affiliation(s)
- A B Hauber
- RTI Health Solutions, Research Triangle Park, NC, USA
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Hauber AB, Gnanasakthy A, Snyder EH, Bala MV, Richter A, Mauskopf JA. Potential savings in the cost of caring for Alzheimer's disease. Treatment with rivastigmine. Pharmacoeconomics 2000; 17:351-360. [PMID: 10947490 DOI: 10.2165/00019053-200017040-00005] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To estimate savings in the cost of caring for patients with Alzheimer's disease (AD) during 6 months, 1 year and 2 years of treatment with rivastigmine. An intermediate objective was to estimate the relationship between disease progression and institutionalisation. DESIGN AND SETTING We assessed the relationship between Mini-Mental State Examination (MMSE) score and institutionalisation using a piecewise Cox proportional hazard model. To estimate cost savings from treatments lasting 6 months, 1 year and 2 years, estimates of the probability of institutionalisation were integrated with data from two 6-month phase III clinical trials of rivastigmine and a hazard model of disease progression. MAIN OUTCOME MEASURES AND RESULTS Our data suggest that savings in the overall cost of caring for patients with mild and moderate AD can be as high as $US4839 per patient after 2 years of treatment. Furthermore, the probability of institutionalisation increases steadily as MMSE score falls. Among our study individuals, age, race, level of education and marital status were significant predictors of institutionalisation, whereas gender had little effect. CONCLUSIONS Using rivastigmine to treat AD results in a delay in disease progression for patients who begin treatment during the mild or moderate stages of the disease. By delaying the probability that a patient will be institutionalised, the cost of caring for AD patients can be significantly reduced.
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Affiliation(s)
- A B Hauber
- Research Triangle Institute, Research Triangle Park, North Carolina, USA
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Hauber AB, Gnanasakthy A, Mauskopf JA. Savings in the cost of caring for patients with Alzheimer's disease in Canada: an analysis of treatment with rivastigmine. Clin Ther 2000; 22:439-51. [PMID: 10823365 DOI: 10.1016/s0149-2918(00)89012-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To estimate per-patient potential cost savings using rivastigmine in the treatment of Alzheimer's disease (AD) in Canada. BACKGROUND In recent years, new members of a class of pharmaceuticals known as cholinesterase inhibitors have been introduced for the treatment of patients with AD. Two recent studies conducted in the United Kingdom and the United States estimated potential cost savings from the new cholinesterase inhibitor rivastigmine. The present study combined the disease-progression model used in those 2 studies with Canadian costs to estimate per-patient potential savings resulting from the treatment of AD in Canada. METHODS Efficacy data from 2 pivotal, phase III clinical trials of rivastigmine were used in a hazard model of disease progression to estimate long-term differences in cognitive functioning between patients receiving rivastigmine and patients receiving no treatment. We used the Mini-Mental State Examination (MMSE) score as our measure of disease progression. We also used Canadian costs of AD care, estimated as a function of MMSE score, to estimate cost savings experienced by treated patients compared with patients receiving no treatment. All costs and cost savings are presented in 1997 Canadian dollars. We used a societal perspective in this analysis. RESULTS Rivastigmine was estimated to delay the transition to more severe stages of AD by up to 188 days for patients with mild AD after 2 years of treatment. For patients with mild-to-moderate and moderate disease, this delay was estimated to be 106 and 44 days, respectively. For patients with the mild stage of AD, estimated average daily cost savings (excluding the cost of rivastigmine) ranged from Can $0.45 per patient per day at 6 months to Can $6.44 per patient per day after 2 years of treatment. For all patients, these estimated average daily cost savings ranged from a low of Can $0.71 per patient per day after 6 months of treatment to a high of Can $4.93 per patient per day after 2 years. CONCLUSION On average, treatment with rivastigmine yields savings in the direct cost of caring for AD patients that exceed the cost of the drug after 2 years of treatment.
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Affiliation(s)
- A B Hauber
- Research Triangle Institute, Center for Economics Research, Research Triangle Park, North Carolina 27709-2194, USA.
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