Reduction of LDL-C Levels is Most Important - Patient Preferences for Drug Treatment Adjunct to LDL-C Apheresis in Severe Hypercholesterolemia

OBJECTIVES: Severe hypercholesterolemia is a major cause of death from coronary heart disease. Statins have been the cornerstone of lipid therapy for the last two decades. New adjunctive drug therapies (PSCK9-inhibitors) passed authorization processes in EU and US and have been launched recently. Th...

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Bibliographic Details
Published in:Value in health 2017-10, Vol.20 (9), p.A622-A623
Main Authors: Mühlbacher, AC, Sadler, A, Dippel, F, Juhnke, C
Format: Article
Language:English
Subjects:
Apheresis
Authorization
Blood
Cardiovascular diseases
Cholesterol
Cognitive ability
Cognitive impairment
Coronary artery disease
Discrete choice
Drug therapy
Efficacy
Heart diseases
Hypercholesterolemia
Hypotension
Low density lipoprotein
Medical treatment
Myopathy
Patients
Preferences
Side effects
Statins
Systematic review
Treatment preferences
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Summary:OBJECTIVES: Severe hypercholesterolemia is a major cause of death from coronary heart disease. Statins have been the cornerstone of lipid therapy for the last two decades. New adjunctive drug therapies (PSCK9-inhibitors) passed authorization processes in EU and US and have been launched recently. The aim of the empirical study was to document patients' preferences with regard to the adjuvant drug therapy of apheresis-treated patients with severe familial hypercholesterolemia. METHODS: A systematic literature search was conducted to identify patient-relevant outcomes. Within N=10 semi-structured interviews the decision model was generated. Seven patient relevant characteristics were identified and described by three levels. For the discrete choice experiment (DCE), an experimental design (7*3) was generated using Ngene-Software. The design consisted of 96 choices, which were divided into 8 blocks. The survey was conducted between November 2015 to April 2016 with computer-assisted personal interviews. RESULTS: N=348 apheresis-treated patients participated (64.9% male). The preference analysis (random parameter logit estimation) showed that patients had clear preferences for all attributes included and that the efficacy criterion "reduction of LDL-C level in blood" (Level Difference/LD: 2.808) was the most significant characteristic in the treatment of hypercholesterolemia. The second rank was taken by "risk of myopathy" (LD: 1.239). In third place was "frequency of apheresis" (LD: 0.821) followed by "risk of cognitive impairment" (LD: 0.554), "number of additional injections" (LD: 0.526) and "risk of hypotension" (LD: 0.341). Within the random parameter logit estimation all coefficients proved to be significant at the level of p
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.08.1361