Discrete Choice Experiment to Assess Treatment Preferences of Patients with Multiple Myeloma, Their Caregivers, and Physicians in Korea (CAREMM-2304)

Background: A fundamental aspect of oncology is the comprehension of patient preferences, as it enables the adaptation of treatments to suit individual requirements, thereby enhancing adherence. This is of particular importance in the context of multiple myeloma (MM) because it necessitates long-term management. An understanding of these preferences enables clinicians to optimize treatment plans and improve outcomes. It is possible that preferences may differ due to a number of factors, including cultural, economic, and healthcare system differences. This study employs a discrete choice experiment (DCE) methodology to investigate the factors influencing treatment preferences in Korea, thereby providing insights for the development of personalized MM treatment strategies. Hereby, we demonstrated results of interim analysis

Methods: This cross-sectional, non-interventional study recruited a total of 132 participants, including MM patients (n = 54), their caregivers (n = 28) from five Korean university hospitals, and Korean physicians who were expert to manage Korean MM patients (n= 50). The study was conducted in two phases: the initial phase, which was qualitative in nature, followed by the main phase. In this qualitative phase, the selected attributes, such as treatment efficacy (Prob), survival years (Year), asymptomatic period (Asym), hospital visit frequency (Freq), daily living limitations (DailyLiving), adverse events (AE), and treatment cost (Cost), were verified with regard to their influence and understanding through the use of in-depth interviews. In the main phase of the study, participants' demographic and clinical characteristics were surveyed, and their preferences were assessed through the administration of DCE questions. The participants were analyzed according to the following variables: respondent group (patients, caregivers, physicians), location of hospital (affluent, less affluent areas), sex (male, female), age (<60, ≥60), education level (high school, university graduates), and marital status (other, married, single). This study is registered in CRIS, No. KCT0009395.

Results: The asymptomatic period and treatment cost were identified as significant factors across the majority of groups. In contrast, the increase in survival was found to be of lesser significance. The cost of treatment was significantly important factor for patients and their caregivers (p < 0.001 and p = 0.036, respectively), as well as subgroup of patients in less affluent areas (p < 0.001). The preferences of probability of treatment efficacy and the increase in survival years were identified as significant for physicians (p < 0.001 for both). Younger patients (<60 years) demonstrated a more expansive range of attributes (Prob, Year, Asym, Freq, DailyLiving), whereas older patients (≥60 years) exhibited a primary concern with treatment costs (p < 0.001). Patients with higher levels of education demonstrated a greater emphasis on treatment efficacy (Prob, Year) and daily living limitations (p < 0.001), whereas those with lower levels of education exhibited a greater concern with adverse events (p = 0.029) and costs (p < 0.001). Married individuals judged daily living limitations (p = 0.03) and cost of treatment (p < 0.001) to be more important preference determinants than those categorized as single or other.

Conclusions: This interim analysis identifies significant factors influencing treatment preferences across various demographic and clinical subgroups. (This collaborative study was financially supported by Jannsen.)