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Patient preferences for osteoporosis in Spain: a discrete choice experiment

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Abstract

Summary

In Spain, various treatments are available to prevent osteoporotic fractures. A discrete choice experiment (DCE) was used to investigate the importance of different treatment aspects and its influence on patients’ preferences. All attributes included as type and place of drug administration as well as costs showed to be significant predictors of choice. Spanish osteoporosis patients have well-defined preferences and accept trade-offs among attributes.

Introduction

This study was designed to identify patient preferences for different aspects of osteoporosis treatments in Spain.

Methods

Main attributes of severe osteoporosis treatments were determined by literature review and consultations with nurses. The discrete choice experiment included three attributes: type of drug administration, place of administration, plus a cost attribute in order to estimate willingness to pay for improvements in attribute levels. A pilot study with 50 patients was performed to identify the areas of misunderstanding. One hundred sixty-six patients with a diagnosis of osteoporosis and severe osteoporosis were presented with pairs of hypothetical treatment profiles with different type of administration levels, places of administration and costs. Questions to collect socio-demographic and disease-related treatment data were also included. Data were analysed using a random effects probit model.

Results

All attributes had the expected polarity and were significant predictors of choice. Patients were willing to pay 183 €/month to have a subcutaneous injection once per day rather than an intravenous injection once per year. Patients with osteoporosis were willing to pay 121 €/month to have medical support when administering the drug treatment at home rather than being admitted several hours to a hospital for drug administration.

Conclusion

Spanish osteoporosis patients have well-defined preferences among treatment attributes and are willing to accept trade-offs among attributes. Participants indicated that they are willing to accept self medication with medical support rather than being hospitalised for several hours. The perspective of the patients should be taken into account when making treatment decisions.

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Acknowledgements

The authors gratefully acknowledge the participation of the nurses and the centres involved in this study: María Alvarez Balbona, Department of Rheumatology, Hospital La Paz, Madrid; Amelia Carbonell, Department of Rheumatology, Hospital San Juan de Alicante; Pilar Cavero, Department of Traumatology, Hospital Miguel Servet, Zaragoza; Montserrat Jordana, Department of Rheumatology, Hospital de Bellvitge, Barcelona; Carmen Prieto, Department of Traumatology, Hospital Alvarez Buylla, Asturias; Ángeles Molina, Department of Rheumatology, Hospital San Cecilio, Granada; Isabel Padró, Department of Rheumatology, Hospital del Mar, Barcelona; Elena Martínez, Medical department, Nycomed Pharma.

Conflicts of interest

Funding for the patients’ preferences for osteoporosis treatment study was obtained from Nycomed Pharma. The funding body had no role in the design of the study, in the analysis of the data and in the writing of the report.

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Authors and Affiliations

  1. Department of Economics, Universitat de Barcelona, Diagonal 690, 08034, Barcelona, Spain

    J. Darbà

  2. BCN Health Economics and Outcomes Research, Barcelona, Spain

    G. Restovic & L. Kaskens

  3. Department of Rheumatology, Hospital La Paz, Madrid, Spain

    M. A. Balbona

  4. Department of Rheumatology, Hospital San Juan de Alicante, Alicante, Spain

    A. Carbonell

  5. Department of Traumatology, Hospital Miguel Servet, Zaragoza, Spain

    P. Cavero

  6. Department of Rheumatology, Hospital de Bellvitge, Barcelona, Spain

    M. Jordana

  7. Department of Traumatology, Hospital Alvarez Buylla, Asturias, Spain

    C. Prieto

  8. Department of Rheumatology, Hospital San Cecilio, Granada, Spain

    Á. Molina

  9. Department of Rheumatology, Hospital del Mar, Barcelona, Spain

    I. Padró

Authors
  1. J. Darbà
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  2. G. Restovic
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  3. L. Kaskens
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  4. M. A. Balbona
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  5. A. Carbonell
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  6. P. Cavero
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  7. M. Jordana
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  8. C. Prieto
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  9. Á. Molina
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  10. I. Padró
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Corresponding author

Correspondence to J. Darbà.

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Darbà, J., Restovic, G., Kaskens, L. et al. Patient preferences for osteoporosis in Spain: a discrete choice experiment. Osteoporos Int 22, 1947–1954 (2011). https://doi.org/10.1007/s00198-010-1382-3

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  • DOI: https://doi.org/10.1007/s00198-010-1382-3

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