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Preferences of Patients with Chronic Hepatitis B – A Discrete Choice Experiment on the Acceptability of Functional Cure

Authors Hardtstock F, Sbarigia U, Kocaata Z, Wilke T, Sylvester SV

Received 15 November 2019

Accepted for publication 27 February 2020

Published 19 March 2020 Volume 2020:14 Pages 613—624


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Fraence Hardtstock, 1,* Urbano Sbarigia, 2,* Zeki Kocaata, 1 Thomas Wilke, 1 Shirley V Sylvester 3

1Ingress-Health HWM GmbH, Wismar 23966, Germany; 2Janssen Pharmaceutica, Beerse 2340, Belgium; 3Janssen Pharmaceuticals, Titusville, NJ 8560, USA

*These authors contributed equally to this work

Correspondence: Fraence Hardtstock
Ingress-Health HWM GmbH, Alter Holzhafen 19, Wismar 23966, Germany
Tel +49-3841-758-1024
Fax +49-3841-7581011

Background: Current antiviral therapies for chronic hepatitis B (CHB) rarely achieve functional cure, thus often requiring lifelong therapy. A therapy achieving functional cure in a significant percentage of patients could change the treatment landscape substantially. However, the acceptability of functional cure by patients is unknown, especially if associated with additional treatment burden.
Methods: A Discrete Choice Experiment (DCE) including patients with CHB was performed between 2018 and 2019 in Germany. Patient inclusion criteria were confirmed CHB; age of at least 18 years; no history of hepatocellular carcinoma; no HIV or HCV/HDV co-infection. The final DCE included the following attributes: route of administration (oral administration by tablets; subcutaneous injection + tablets; intramuscular electroporation + tablets), side effect frequency (0/1/3 days per month), functional cure (1%/30%/50% of patients), frequency of physician visits (monthly, half-yearly) and travel time to treating physician (15/45 min).
Results: The main analysis sample consisted of 108 patients with CHB (mean age: 49.1 years, female: 37.0%, average time since CHB diagnosis: 14.0 years, 52.8% with Hepatitis B surface antigen (HBsAg) chronic HBV infection). High efficacy was found to be the main driver of decisions for/against the presented treatment options (impacted 57% of patients’ decisions), followed by therapy regimen (17%), safety profile (12%) and number of physician visits (11%). Latent class analysis revealed first insights into different decision patterns, with age, gender and previous side-effect experience affecting patients’ decisions.
Conclusion: In comparison to all other treatment-related attributes such as therapy regimen or safety profile, patients with CHB showed a strong preference towards a scenario where a substantial number of patients benefit from sustained disease remission, which mimics functional cure.

Keywords: hepatitis B, antiviral therapies, sustained virologic response, functional cure, discrete choice experiment, patient preferences

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