Objective: To quantify patient preferences for on-demand treatments among patients with Parkinson’s disease (PD) and “OFF” episodes.

Background: Patients with PD develop potentially disabling “OFF” episodes—periods when symptoms worsen or reemerge—that may be treated with on-demand therapies.

Method: Carbidopa/levodopa-treated adults (age 18–75 years) from the US with self-reported PD for ≥5 years or <5 years with “OFF” episodes were recruited for an online discrete-choice experiment survey. Respondents selected between pairs of experimentally designed profiles for hypothetical on-demand “OFF” treatments that varied by mode of administration (with and without mode-specific adverse events [AEs]), time to FULL “ON,” duration of “ON,” and out-of-pocket cost for 30 doses. Data were analyzed by a random parameters logit model, and results were used to calculate the relative importance of treatment attributes and willingness to pay (WTP).

Results: Nearly all (98%) of the 300 respondents had “OFF” episodes. Among the attribute levels given, the least important was increasing the duration of “ON” from 1 to 2 hours. The most important attribute was avoiding a $90 cost (9.7× as important as duration of “ON”), then change in mode of administration from injection with site reactions to dissolvable sublingual film without mouth/lip sores (8.9× as important as duration of “ON”), followed by decreasing time to “ON” from 60 to 15 minutes (6.2× as important as duration of “ON”). Given a choice in mode of administration, dissolvable sublingual film with potential mouth/lip sores was preferred over inhalation with potential cough or mild respiratory infection (2.2× as important) or injection with potential site reactions (4.7× as important). Average WTP to move from an injection with site reactions (least preferred) to a dissolvable sublingual film without AEs (most preferred) was $83. Average WTP to decrease time to FULL “ON” from 60 to 15 minutes was $58.

Conclusion: Based on the attributes and levels given, patients with PD placed the most importance on avoiding high out-of-pocket costs and mode of administration when choosing an on-demand treatment for “OFF” episodes. Time to FULL “ON” was also an important driver of choice.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-discrete-choice-experiment-evaluating-preferences-for-on-demand-treatments-for-patients-with-parkinsons-disease-and-off-episodes/