Feldman SR, Poulos C, Gilloteau I, Mange B, Boehm K, Boeri M, Naatz M, Augustin M. Exploring determinants of psoriasis patients' treatment choices: a discrete-choice experiment study in the United States and Germany. J Dermatolog Trea. 2021 Feb 3;1-10. doi: 10.1080/09546634.2020.1839007

BACKGROUND: Biologic psoriasis treatments are differentiated by efficacy, side effects, and other attributes.

OBJECTIVE: Determine attributes of biologic psoriasis treatments that drive patients’ treatment choices.

METHODS: Respondents (US: n=300; Germany: n=300) with moderate-to-severe psoriasis completed a discrete-choice–experiment survey, choosing between hypothetical treatments characterized by attributes with varying levels: chance of clear skin after 1 year, number of first-year treatments, first-year risks of mild-to-moderate injection site reaction (ISR) and serious infection, and years of proven efficacy/safety.

RESULTS: US respondents most valued clear skin (conditional relative importance, 1.88; P<0.05). While other attributes were of generally equivalent importance, ISR risk outweighed serious-infection risk (1.06 vs. 0.70; P<0.05). German respondents placed greatest importance on ISR risk (1.61; P<0.05) and clear skin (1.49; P<0.05).

LIMITATIONS: Respondents evaluated hypothetical treatments and were recruited from web panels.

CONCLUSIONS: Clear skin and ISR risk are stronger drivers of treatment choice than injection frequency and infection risk.