Authors: Caroline M Vass, Anne Barton & Katherine Payne
Abstract
Introduction
There have been promising developments in technologies and associated algorithm-based prescribing (‘stratified approach’) to target biologics to sub-groups of people with rheumatoid arthritis (RA). The acceptability of using an algorithm-guided approach in practice is likely to depend on various factors.
Objective
This study quantified preferences for an algorithm-guided approach to prescribing biologics (termed ‘biologic calculator’).
Methods
An online discrete choice experiment (DCE) was designed to elicit preferences from patients and the public for using a ‘biologic calculator’ compared with conventional prescribing. Treatment approaches were described by five attributes: delay to starting treatment; positive and negative predictive value (PPV/NPV); risk of infection; and cost saving to the UK national health service. Each survey contained six choice sets asking respondents to select their preferred option from two hypothetical biologic calculators or conventional prescribing. Background questions included sociodemographics, health status and healthcare experiences. DCE data were analysed using mixed logit models.
Results
Completed choice data were collected from 292 respondents (151 patients with RA and 142 members of the public). PPV, NPV and risk of infection were the most highly valued attributes to respondents deciding between prescribing strategies.
Conclusion
Respondents were generally receptive to personalised medicine in RA, but researchers developing personalised approaches should pay close attention to generating evidence on both the PPV and the NPV of their technologies.
Key Points for Decision Makers |
A growing body of research is investigating how rheumatoid arthritis treatments such as biologics may be targeted to those who would benefit the most. |
Despite research and development being directed towards prescribing algorithms to target medicines such as biologics, whether patients or potential patients are receptive to these new approaches and what drives their preferences remain unknown. |
On average, patients and members of the public preferred the stratified approach. |