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.
Bibliographical noteHERU 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
- benign prostatic hyperplasia
- discrete choice experiment
- erectile dysfunction
- urinary tract symptoms
- storage symptoms
- urge incontinence