Patient preferences among third agent HIV medications: a US and German perspective

• Published in: AIDS care 2007-09, Vol.19 (8), p.982-988
• Main Authors: Beusterien, K. M., Dziekan, K., Schrader, S., Flood, E., Flood, R., Shearer, A., Davis, E. A.
• Format: Article
• Language: English
• Subjects: American people; Anti-Retroviral Agents - pharmacology; Anti-Retroviral Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Attitudes; Biological and medical sciences; Drug Administration Schedule; Drug Interactions; Drug resistance; Drug Resistance, Viral; Drug therapy; Drugs; Effectiveness studies; Female; German people; Germany; Germany - epidemiology; Health care; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Protease Inhibitors - pharmacology; HIV Protease Inhibitors - therapeutic use; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Lopinavir; Male; Medical sciences; Medical treatment; Patient Satisfaction - statistics & numerical data; Patients; Pharmacology. Drug treatments; Preferences; Protease inhibitors; Pyrimidinones - pharmacology; Pyrimidinones - therapeutic use; Risk factors; Ritonavir - pharmacology; Ritonavir - therapeutic use; Therapy; Treatment Outcome; Treatment preferences; U.S.A; United States - epidemiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540120701294278

The objective is to assess patient preferences for attributes associated with third agent HIV medications, including fosamprenavir/ritonavir (FPVr), fosamprenavir (FPV), lopinavir/ritonavir (LPVr), atazanavir (ATZ), and efavirenz (EFV). Subjects with HIV were recruited in the US and Germany to complete a computerized adaptive conjoint survey that assessed 13 attributes, including moderate to severe side effects, regimen convenience, drug resistance and efficacy. Literature on the target third-agent HIV drugs was used to identify percentage risk and severity level descriptions for each attribute. The derived preference (utility) weights for each attribute level informed the calculation of relative importance estimates for each attribute and the desirability of combinations of attributes matching the respective target third agents. The analysis included 288 HIV-positive participants (US: 132; Germany: 156), 205 of whom were treatment-experienced and 83 of whom were treatment-naïve. Of the 13 medication attributes evaluated, developing drug resistance, the risk of lipodystrophy, the risk of gastronitestinal side effects (diarrhoea, nausea and vomiting) and regimen convenience had the greatest impact on preferences. The profile based on FPVr was most preferred. Differences in the risk of developing drug resistance, risk of lipodystrophy, risk of gastrointestinal side effects and regimen convenience would likely be most influential in the perceived relative value of a third-agent medication. Physicians may wish to consider these features, especially when discussing HIV treatment options with their patients.