Physicians' preferences for bone metastases drug therapy in the United States

Jorge Arellano; A Brett Hauber; Ateesha F Mohamed; Juan Marcos Gonzalez; Helen Collins; Guy Hechmati; Francesca Gatta; Yi Qian

doi:10.1016/j.jval.2014.10.004

Physicians' preferences for bone metastases drug therapy in the United States

Value Health. 2015 Jan;18(1):78-83. doi: 10.1016/j.jval.2014.10.004.

Authors

Jorge Arellano¹, A Brett Hauber², Ateesha F Mohamed², Juan Marcos Gonzalez², Helen Collins¹, Guy Hechmati³, Francesca Gatta³, Yi Qian⁴

Affiliations

¹ Amgen, Inc., Thousand Oaks, CA, USA.
² RTI Health Solutions, Research Triangle Park, NC, USA.
³ Amgen (Europe) GmbH, Zug, Switzerland.
⁴ Amgen, Inc., Thousand Oaks, CA, USA. Electronic address: yiq@amgen.com.

PMID: 25595237
DOI: 10.1016/j.jval.2014.10.004

Abstract

Objective: Several characteristics of bone-targeted agents are considered when making treatment decisions. This study evaluated physicians' therapy preferences for preventing skeletal-related events (SREs) in patients with bone metastases secondary to solid tumors.

Methods: A Web-enabled, discrete-choice experiment online survey was conducted among physicians who treated patients with bone metastases and solid tumors in the United States. Respondents chose between pairs of hypothetical medications defined by combinations of six attributes at varying levels for two hypothetical patients. Preference weights for attribute levels were estimated using a random-parameters logit model.

Results: In total, 200 physicians completed the survey. Their mean age was 52 years, 57% were in practice for more than 15 years, 37% were oncologists, and 65% treated 10 or fewer patients with bone metastases weekly. Out-of-pocket cost to patients was the most important attribute overall. Among clinical outcomes, time to first SRE and risk of renal impairment were the most important attributes. Statistically significant preferences were observed for all attribute levels for time to first SRE, risk of renal impairment, and mode of administration. Predicted choice probability analysis showed that physicians preferred a hypothetical medication with attributes similar to those of denosumab over one with attributes similar to those of zoledronic acid.

Conclusions: Physicians indicated that clinical attributes are important when considering bone-targeting therapy for bone metastases, but consistent with the current health care landscape, patient out-of-pocket cost was the most important. With health care costs being increasingly shifted to patients, physicians require accurate information about co-pays and assistance programs to avoid patients receiving less costly, yet potentially inferior, treatment.

Keywords: bone metastases; conjoint analysis; discrete-choice experiment; drug therapy attributes; preferences; skeletal-related events; treatment.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antineoplastic Agents / adverse effects
Attitude of Health Personnel*
Bone Density Conservation Agents / adverse effects
Bone Diseases / chemically induced
Bone Diseases / prevention & control
Bone Neoplasms / drug therapy*
Bone Neoplasms / epidemiology
Bone Neoplasms / secondary*
Data Collection / methods*
Female
Humans
Male
Middle Aged
Physician's Role*
United States / epidemiology

Substances

Antineoplastic Agents
Bone Density Conservation Agents