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BMC Cancer
Published in: BMC Cancer 1/2020

01-12-2020 | Multiple Myeloma | Research article

Alignment of preferences in the treatment of multiple myeloma – a discrete choice experiment of patient, carer, physician, and nurse preferences

Authors: Simon J. Fifer, Kerrie-Anne Ho, Sean Lybrand, Laurie J. Axford, Steve Roach

Published in: BMC Cancer | Issue 1/2020

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Abstract

Background

Multiple Myeloma (MM) is a cancer characterised by the proliferation of malignant plasma cells in the bone marrow. This study examined the treatment preferences of people living with MM compared to the treatment preferences of other groups involved in treatment decision making, including carers, as well as physicians and nurses who treat people living with MM in Australia.

Methods

Data were collected using discrete choice experiments (DCEs) through an online survey. The DCEs presented participants with a traditional treatment generic choice experiment (e.g., treatment A vs treatment B), focusing on the clinical benefits of treatments and the associated risks. The attributes and levels of the attributes were selected based on previous research, literature review, qualitative research and expert opinion. The DCE data were modelled using a Latent Class Model (LCM).

Results

The model revealed significant heterogeneity in preferences for treatment attributes. In particular, overall survival, remission period and annual out of pocket cost were the attributes with the most variation. In comparison to people living with MM, carers were less cost-sensitive and more concerned with quality of life (remission period). Physicians and nurses were generally more concerned with overall survival and more cost sensitive than people living with MM.

Conclusions

This study demonstrated that not all people living with MM valued the same treatment attributes equally. Further, not all groups involved in MM treatment decision making had preference alignment on all treatment attributes. This has important implications for healthcare policy decisions and shared decision making. Results from this study could be used to guide decisions around the value of new MM medicines or the medical plan surrounding the needs of those living with MM, as well as those caring for them.
Footnotes
1
Note that the description relevant to cost attribute presented in Figure 1 was presented differently for each respondent subgroup. For patients, it was “average out of pocket cost to you over a year” whereas for other groups “average out of pocket cost to the patient over a year”.
 
2
Other than patients, data was not sufficient to estimate each subgroup separately.
 
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Metadata
Title
Alignment of preferences in the treatment of multiple myeloma – a discrete choice experiment of patient, carer, physician, and nurse preferences
Authors
Simon J. Fifer
Kerrie-Anne Ho
Sean Lybrand
Laurie J. Axford
Steve Roach
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2020
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-020-07018-6

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