Patient Preference and Adherence (Mar 2022)

Preferences and Priorities for Relapsed Multiple Myeloma Treatments Among Patients and Caregivers in the United States

  • Auclair D,
  • Mansfield C,
  • Fiala MA,
  • Chari A,
  • Cole CE,
  • Kaufman JL,
  • Orloff GJ,
  • Siegel DS,
  • Zonder JA,
  • Mange B,
  • Yesil J,
  • Dalal M,
  • Mikhael JR

Journal volume & issue
Vol. Volume 16
pp. 573 – 585

Abstract

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Daniel Auclair,1,* Carol Mansfield,2,* Mark A Fiala,3,* Ajai Chari,4 Craig E Cole,5 Jonathan L Kaufman,6 Gregory J Orloff,7 David S Siegel,8 Jeffrey A Zonder,9 Brennan Mange,2 Jennifer Yesil,1 Mehul Dalal,10 Joseph R Mikhael11 1Department of Research, Multiple Myeloma Research Foundation, Norwalk, CT, USA; 2RTI Health Solutions, Research Triangle Park, NC, USA; 3Division of Hematology & Oncology, Washington University School of Medicine, St. Louis, MO, USA; 4Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA; 5Department of Medicine, MSU Breslin Cancer Center, Lansing, MI, USA; 6Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA; 7Virginia Cancer Specialists, Fairfax, VA, USA; 8John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA; 9Division of Clinical Hematology-Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA; 10Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical, Company Ltd, Cambridge, MA, USA; 11Translational Genomic Research Institute, City of Hope Cancer Center, Phoenix, AZ, USA*These authors contributed equally to this workCorrespondence: Daniel Auclair, AstraZeneca Oncology R&D| Hematology, 35 Gatehouse Drive, Waltham, MA, 02451, USA, Email [email protected]/Background: This study aimed to describe patient and caregiver preferences for treatments of relapsed or refractory multiple myeloma (MM).Materials and Methods: A survey including discrete-choice experiment (DCE) and best-worst scaling (BWS) exercises was conducted among US patients with relapsed or refractory MM and their caregivers. The DCE included six attributes with varying levels including progression-free survival (PFS), toxicity, and mode and frequency of administration. In addition, the impact of treatment cost was assessed using a fixed-choice question. The BWS exercise included 18 items (modes and frequency of administration, additional treatment convenience, and toxicity items). The survey was administered online to patients recruited from the Multiple Myeloma Research Foundation CoMMpass study (NCT01454297).Results: The final samples consisted of 94 patients and 32 caregivers. Avoiding severe nerve damage was most important to patients, followed by longer PFS. Caregivers considered PFS to be the most important attribute. We estimate that a third or more of patients were cost-sensitive, meaning their treatment preference was altered based on cost implications. Caregivers were not cost-sensitive. The three most bothersome treatment features in the BWS exercise were risk of kidney failure, lowering white blood cell counts, and weakening the immune system.Conclusion: Patients with relapsed or refractory MM and their caregivers consider many factors including efficacy, toxicity, mode/frequency of administration, and cost in their decisions regarding treatment options. The study provides a basis for future Research on patient and caregiver treatment preferences, which could be incorporated into shared decision-making with physicians.Keywords: discrete choice experiment, preference, patient, caregiver, multiple myeloma

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