Patients’ Preferences for Atopic Dermatitis Treatments in Europe: A Discrete Choice Experiment

OBJECTIVES: This study aimed to investigate atopic dermatitis (AD) patients’ preferences for AD treatment attributes.

METHODS: We conducted a discrete choice experiment with adult AD patients in Europe. Attributes and levels were defined by literature search, consultations with AD patients, dermatologists, and preference research experts. Six attributes (itch reduction, time to onset of action, risk of serious infection, mode and frequency of administration, long-term disease management, availability on the market) with three to four levels each were chosen. The questionnaire incorporated 15 hypothetical discrete-choice tasks, including a dominance test, with two options each, in which participants were asked to choose the preferred treatment. Conditional relative importance of every attribute was calculated.

RESULTS: Thirty-nine AD patients were included in the analysis (82% female, mean age 41 years). Significant coefficients were observed for all attributes except for availability on the market. The efficacy attribute (itch reduction) was the most important for patients (48%), followed by infection risk (22%), mode of administration (11%) and long-term disease management (10%). Time of onset seemed to play a minor role (7%) and availability on the market was least important (2%). Overall, directions of preferences were in line with expectations, with availability on the market as an exception. From given choices, emollients twice a day was the preferred mode of administration. The use of preservatives in emollients was relevant for AD patients who seemed to prefer emollients without preservatives. Furthermore, self-injections every other week were preferred over oral pills daily.

CONCLUSIONS: This study identified which treatment characteristics are most important for AD patients. Insights gained about the mode of administration and usage of preservatives add to the current knowledge. This study’s findings can improve shared-decision making, acceptance of therapies as well as treatment development. Additional data are being collected to confirm these findings.