Men’s preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment

Colette Mankowski; Divine Ikenwilo; Sebastian Heidenreich; Mandy Ryan; Jameel Nazir; Cathy  Newman; Verity Watson

doi:10.2147/PPA.S112161

Men’s preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment

Colette Mankowski, Divine Ikenwilo, Sebastian Heidenreich, Mandy Ryan, Jameel Nazir, Cathy Newman, Verity Watson

Health Economics and Outcomes Research, Astellas Pharma Europe Ltd., Chertsey

Research output: Contribution to journal › Article › peer-review

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Abstract

OBJECTIVE: To explore and quantify men's preferences and willingness to pay (WTP) for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment.

SUBJECTS AND METHODS: Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8) were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia) urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes.

RESULTS: In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level), but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency), and £6.65/month and £1.39/month for each unit reduction in night- and daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild urgency and no fluid during ejaculation (dry orgasm).

CONCLUSION: To compensate for side effects, a medicine for lower urinary tract symptoms/benign prostatic hyperplasia must provide a combination of benefits, such as reduced urgency of urination plus reduced nighttime and/or reduced daytime urination.

Original language	English
Pages (from-to)	2407-2417
Number of pages	11
Journal	Patient preference and adherence
Volume	2016
Issue number	10
DOIs	https://doi.org/10.2147/PPA.S112161
Publication status	Published - 24 Nov 2016

Bibliographical note

HERU is supported by the Chief Scientist Office (CSO) at the Scottish Government Health and Social Care Directorate. Sebastian Heidenreich acknowledges financial support from the Institute of Applied Health Science, University of Aberdeen. Medical writing support was provided by Tyrone Daniel from Bioscript Medical, and was funded by Astellas Pharma Europe Ltd. Presented in part as a poster at the ISPOR 17th Annual European Congress, November
8–12, 2014, Amsterdam, The Netherlands. The poster’s abstract was published in Value in Health. 2014;17 (7):A472.

Open Access Journal

Keywords

benign prostatic hyperplasia
discrete choice experiment
erectile dysfunction
urinary tract symptoms
storage symptoms
urge incontinence

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Men’s preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment
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Cite this

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abstract = "OBJECTIVE: To explore and quantify men's preferences and willingness to pay (WTP) for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment.SUBJECTS AND METHODS: Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8) were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia) urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes.RESULTS: In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level), but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency), and £6.65/month and £1.39/month for each unit reduction in night- and daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild urgency and no fluid during ejaculation (dry orgasm).CONCLUSION: To compensate for side effects, a medicine for lower urinary tract symptoms/benign prostatic hyperplasia must provide a combination of benefits, such as reduced urgency of urination plus reduced nighttime and/or reduced daytime urination.",

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note = "HERU is supported by the Chief Scientist Office (CSO) at the Scottish Government Health and Social Care Directorate. Sebastian Heidenreich acknowledges financial support from the Institute of Applied Health Science, University of Aberdeen. Medical writing support was provided by Tyrone Daniel from Bioscript Medical, and was funded by Astellas Pharma Europe Ltd. Presented in part as a poster at the ISPOR 17th Annual European Congress, November 8–12, 2014, Amsterdam, The Netherlands. The poster{\textquoteright}s abstract was published in Value in Health. 2014;17 (7):A472. Open Access Journal ",

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AU - Ikenwilo, Divine

AU - Heidenreich, Sebastian

AU - Ryan, Mandy

AU - Nazir, Jameel

AU - Newman, Cathy

AU - Watson, Verity

N1 - HERU is supported by the Chief Scientist Office (CSO) at the Scottish Government Health and Social Care Directorate. Sebastian Heidenreich acknowledges financial support from the Institute of Applied Health Science, University of Aberdeen. Medical writing support was provided by Tyrone Daniel from Bioscript Medical, and was funded by Astellas Pharma Europe Ltd. Presented in part as a poster at the ISPOR 17th Annual European Congress, November 8–12, 2014, Amsterdam, The Netherlands. The poster’s abstract was published in Value in Health. 2014;17 (7):A472. Open Access Journal

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N2 - OBJECTIVE: To explore and quantify men's preferences and willingness to pay (WTP) for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment.SUBJECTS AND METHODS: Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8) were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia) urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes.RESULTS: In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level), but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency), and £6.65/month and £1.39/month for each unit reduction in night- and daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild urgency and no fluid during ejaculation (dry orgasm).CONCLUSION: To compensate for side effects, a medicine for lower urinary tract symptoms/benign prostatic hyperplasia must provide a combination of benefits, such as reduced urgency of urination plus reduced nighttime and/or reduced daytime urination.

AB - OBJECTIVE: To explore and quantify men's preferences and willingness to pay (WTP) for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment.SUBJECTS AND METHODS: Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8) were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia) urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes.RESULTS: In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level), but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency), and £6.65/month and £1.39/month for each unit reduction in night- and daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild urgency and no fluid during ejaculation (dry orgasm).CONCLUSION: To compensate for side effects, a medicine for lower urinary tract symptoms/benign prostatic hyperplasia must provide a combination of benefits, such as reduced urgency of urination plus reduced nighttime and/or reduced daytime urination.

KW - benign prostatic hyperplasia

KW - discrete choice experiment

KW - erectile dysfunction

KW - urinary tract symptoms

KW - storage symptoms

KW - urge incontinence

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DO - 10.2147/PPA.S112161

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SN - 1177-889X

VL - 2016

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JO - Patient preference and adherence

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Men’s preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment

Abstract

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Keywords

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