The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Understanding Preferences for Disease-Modifying Drugs in Osteoarthritis†
Article first published online: 28 JUL 2014
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 8, pages 1186–1192, August 2014
How to Cite
Fraenkel, L., Suter, L., Cunningham, C. E. and Hawker, G. (2014), Understanding Preferences for Disease-Modifying Drugs in Osteoarthritis. Arthritis Care Res, 66: 1186–1192. doi: 10.1002/acr.22280
- Issue published online: 28 JUL 2014
- Article first published online: 28 JUL 2014
- Accepted manuscript online: 27 JAN 2014 01:51PM EST
- Manuscript Accepted: 7 JAN 2014
- Manuscript Received: 17 SEP 2013
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- NIH. Grant Number: AR060231-01
- Centers for Medicare and Medicaid Services. Grant Numbers: HHSM-500-2008-0025I/HHSM-500-T0001, 000008
- Jack Laidlaw Chair in Patient-Centered Health Care
- F.M. Hill Chair in Academic Women's Medicine
Numerous disease-modifying drugs for osteoarthritis (DMOADs) are under investigation. However, patients' preferences for drugs to prevent progression of OA are not known. The objective of this study was to quantify patient preferences for potential DMOADs.
We administered a conjoint analysis survey to 304 patients attending outpatient general medicine and specialty clinics. All patients seated in the waiting rooms were asked if they would participate in a survey to elicit opinions about arthritis treatments. We performed simulations to estimate preferences for 4 options to prevent worsening of knee OA: best case (pill, highest benefit, lowest risk, lowest cost), worst case (infusion, lowest benefit, highest risk, highest cost), moderate subcutaneous injection (injection, mid-level benefit, mid-level risk, mid-level cost), and moderate infusion (same as subcutaneous injection except administered by infusion).
Subjects' median age was 57 years; 55% were women and 76% were white. Segmentation analyses revealed 4 patterns of preferences. A minority (5%) did not want to perform subcutaneous injections and would only consider DMOADs under the best-case scenario. Approximately 20% were risk sensitive and were willing to take DMOADs under the best-case scenario, but would start rejecting these medications as risk increased. A significant number rejected DMOADs under all conditions (16.4%); however, the largest segment (59.2%) had a strong preference for DMOADs across all scenarios.
Our results suggest that a significant percentage of a nonselected outpatient population might be willing to accept at least a moderate degree of risk in order to prevent worsening knee OA.