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(Chest. 2004;125:916-923.)
© 2004 American College of Chest Physicians

Asthma Treatment Preference Study*

A Conjoint Analysis of Preferred Drug Treatments

Gunnar Johansson, MD, PhD; Björn Ställberg, MD; Göran Tornling, MD, PhD, FCCP; Stina Andersson, DHS, MSC; Göran S. Karlsson, PhD; Krister Fält, MBA and Fredrik Berggren, PhD

* From the Department of Public Health and Caring Sciences (Drs. Johansson and Ställberg), Uppsala University, Uppsala; AstraZeneca Research and Development, Lund; (Drs. Tornling and Berggen), AstraZeneca Sweden (Dr. Karlsson and Ms. Andersson), Södertälje; KW Partners (Mr. Fält), Stockholm, Sweden.

Correspondence to: Gunnar Johansson, MD, PhD, Nyby Vårdcentral, Vårdcentral, Heidenstamsgatan 69, S-754 27 Uppsala, Sweden; e-mail: gunnar.johansson{at}lul.se

Objective: Assessment of patient preferences for attributes of asthma treatments.

Methods: Two hundred ninety-eight patients (age range, 18 to 60 years) from 15 centers in Sweden completed a questionnaire concerning their asthma, and ranked 18 alternative treatments using conjoint analysis. Patients were receiving treatment with either inhaled corticosteroids (ICS) and short-acting bronchodilator (n = 123) or ICS and long-acting bronchodilator (separate inhalers, n = 87; combination inhaler, n = 88). Attributes analyzed were maintenance treatment, additional reliever, time to onset and duration of reliever, number of symptom-free days (SFDs) per month, and out-of-pocket cost per month.

Results: Conjoint analysis showed that the most important aspect of treatment was SFD. Forty percent of the patients had <= 15 SFDs per month. Eighty-five percent of the patients preferred another treatment over their current treatment. Treatment preferences were heterogeneous, and in 78% were not covered by current treatment guidelines. A total of 148 patients (50%) preferred a combination inhaler to separate inhalers, and 233 patients (78%) preferred a reliever that is both rapid and long acting. The most preferred treatment was a combination inhaler for maintenance and reliever use. On average, the patients were willing to pay an additional 328 Swedish krona [US $36] per month for the change to the preferred treatment.

Conclusion: SFDs were the most important attribute in asthma treatment. Patients were willing to pay for a switch to their preferred treatment. The most favored treatments were a reliever therapy that is both rapid and long acting and a combination inhaler for both maintenance and as-needed use.

Key Words: asthma treatment • conjoint analysis • treatment preferences




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