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Neurology and Therapy
Published in: Neurology and Therapy 2/2023

Open Access 27-02-2023 | Migraine | ORIGINAL RESEARCH

Discrete Choice Experiment to Understand Japanese Patients’ and Physicians’ Preferences for Preventive Treatments for Migraine

Authors: Jaein Seo, Tommi Tervonen, Kaname Ueda, Dian Zhang, Daisuke Danno, Antje Tockhorn-Heidenreich

Published in: Neurology and Therapy | Issue 2/2023

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Abstract

Introduction

Self-injectable calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) auto-injectors and non-CGRP oral medications are currently available for migraine prevention in Japan. This study elicited the preferences for self-injectable CGRP mAbs and non-CGRP oral medications and determined differences in the relative importance of auto-injector attributes for patients and physicians in Japan.

Methods

Japanese adults with episodic (EM) or chronic (CM) migraine and physicians who treat migraine completed an online discrete choice experiment (DCE), asking participants to choose a hypothetical treatment they preferred between two self-injectable CGRP mAb auto-injectors and a non-CGRP oral medication. The treatments were described by seven treatment attributes, with attribute levels varying between questions. DCE data were analyzed using a random-constant logit model to estimate relative attribution importance (RAI) scores and predicted choice probabilities (PCP) of CGRP mAb profiles.

Results

A total of 601 patients (79.2% with EM, 60.1% female, mean age: 40.3 years) and 219 physicians (mean length of practice: 18.3 years) completed the DCE. About half (50.5%) of patients favored CGRP mAb auto-injectors, while others were skeptical of (20.2%) or averse (29.3%) to them. Patients most valued needle removal (RAI = 33.8%), shorter injection duration (RAI = 32.1%), and auto-injector base shape and need for skin pinching (RAI = 23.2%). Most physicians (87.8%) favored auto-injectors over non-CGRP oral medications. Physicians most valued less-frequent dosing RAI = 32.7%), shorter injection duration (30.4%), and longer storage outside the fridge (RAI = 20.3%). A profile comparable to galcanezumab showed a higher likelihood of being chosen by patients (PCP = 42.8%) than profiles comparable to erenumab (PCP = 28.4%) and fremanezumab (PCP = 28.8%). The PCPs of the three profiles were similar among physicians.

Conclusion

Many patients and physicians preferred CGRP mAb auto-injectors over non-CGRP oral medications and preferred a treatment profile similar to galcanezumab. Our results may encourage physicians in Japan to consider patient preferences when recommending migraine preventive treatments.
Appendix
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Metadata
Title
Discrete Choice Experiment to Understand Japanese Patients’ and Physicians’ Preferences for Preventive Treatments for Migraine
Authors
Jaein Seo
Tommi Tervonen
Kaname Ueda
Dian Zhang
Daisuke Danno
Antje Tockhorn-Heidenreich
Publication date
27-02-2023
Publisher
Springer Healthcare
Published in
Neurology and Therapy / Issue 2/2023
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI
https://doi.org/10.1007/s40120-023-00453-0

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