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The European Journal of Health Economics
Published in: The European Journal of Health Economics 2/2017

01-03-2017 | Original Paper

Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment

Authors: Axel C. Mühlbacher, John F. P. Bridges, Susanne Bethge, Ch.-Markos Dintsios, Anja Schwalm, Andreas Gerber-Grote, Matthias Nübling

Published in: The European Journal of Health Economics | Issue 2/2017

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Abstract

Background

The German Institute for Quality and Efficiency in Health Care (IQWiG) uses patient-relevant outcomes to inform decision-makers.

Objective

IQWiG conducted a pilot study to examine whether discrete choice experiments (DCEs) can be applied in health economic evaluations in Germany to identify, weight, and prioritize multiple patient-relevant outcomes, using the example of antiviral therapy for chronic hepatitis C (HCV). A further objective was to contribute to a more structured approach towards eliciting and comparing preferences across key stakeholders.

Methods

In autumn 2010, a DCE questionnaire was sent to patients with chronic HCV to estimate preferences across seven outcomes (“attributes”), including treatment efficacy [sustained viral response (SVR) at 6 months], adverse effects (flu-like symptoms, gastrointestinal symptoms, psychiatric symptoms, and skin symptoms/alopecia), and measures of treatment burden (duration of therapy, frequency of injections). A linear model and an effects coded full model were applied to assess the relative importance of the attributes.

Results

In total N = 326 patients were included. A clear preference for SVR was shown; frequency of injections and duration of therapy shared the second rank, while psychiatric symptoms ranked third. The duration of flu-like symptoms was the least important attribute.

Conclusion

Our findings indicate that it is possible to perform a DCE at the national level in a health technology assessment agency. The weighting of multiple outcomes allows an indication-specific and evidence-based measure to be used in health economic evaluations. In decision-making in health care, the approach generally allows for consideration of patient-relevant trade-offs regarding the benefits and harms of medical interventions.
Footnotes
1
Note The present pilot study on the treatment of HCV uses attributes and outcomes that might not necessarily correspond to patient-relevant outcomes pursuant to SGB V (i.e., outcomes describing morbidity, mortality, and health-related quality of life). It cannot be concluded from the language used in the present paper that IQWiG would regard the attributes and outcomes applied to represent (patient-relevant) outcomes in the event of a benefit assessment.
 
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Metadata
Title
Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment
Authors
Axel C. Mühlbacher
John F. P. Bridges
Susanne Bethge
Ch.-Markos Dintsios
Anja Schwalm
Andreas Gerber-Grote
Matthias Nübling
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 2/2017
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-016-0763-8

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