Understanding patient preferences in anti-VEGF treatment options for age-related macular degeneration

PLoS One. 2022 Aug 11;17(8):e0272301. doi: 10.1371/journal.pone.0272301. eCollection 2022.

Abstract

Purpose: (1) To investigate the relative importance of convenience (consultation frequency and injection frequency) against treatment outcomes (visual and anatomical outcomes) and out-of-pocket medical costs via a discrete choice experiment (DCE), and (2) to investigate how patient characteristics affect patient treatment preferences.

Methods: Eligibility criteria were: (1) receiving a neovascular age-related macular degeneration (nAMD) diagnosis; (2) receiving anti-VEGF treatment; (3) being ≥21 years old, and (4) being able to speak and understand English/Mandarin. Patients were presented with eight choice tasks and asked to choose between their current treatment and two hypothetical treatments that varied by six attributes: number of clinic visits in a year, number of injections in a year, vision quality, control of swelling in retina, drug labelling and out-of-pocket cost.

Results: This analysis involved 180 patients. Based on latent class logistic regressions, vision quality was the most important attribute (34%) followed by cost (24%). The frequency of total clinic visits (15%) was the third most-important attribute, closely followed by labelling (12%) and control of retina swelling (11%). Injection frequency was the least important attribute (4%).

Conclusions: Vision quality was the most important attribute followed by the out-of-pocket costs. Given the same outcomes, patients preferred treatment regimens which require fewer total clinic visits. In comparison, injection frequency alone did not influence patient preferences. With increasing treatment options for nAMD, understanding patients' preferences can help clinicians in selecting agents and treatment regimen most preferred for each patient, which may lead to improved long-term adherence and outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Degeneration* / drug therapy
  • Patient Preference*
  • Ranibizumab / therapeutic use
  • Vascular Endothelial Growth Factor A / therapeutic use
  • Vascular Endothelial Growth Factors
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors
  • Ranibizumab

Grants and funding

This study was funded by Novartis (Singapore), grant number: R-913-301-510-592. The funder participated in the design of the study, the approval of the manuscript, and the decision to submit the manuscript for publication. The funder had no role in the collection, management, analysis, and interpretation of the data; preparation, and review of the manuscript.