Patient medication preferences in follicular lymphoma in the United States: a discrete choice experiment

Recent therapeutic advances have improved survival for patients with relapsed or refractory follicular lymphoma (R/R FL). Given variations in treatment attributes, understanding patient preference is critical. A discrete choice experiment survey was conducted to assess treatment preferences among patients with R/R FL.

The survey was conducted from 04/2024-05/2024 among United States adults with R/R FL, recruited through online patient panels, physician referrals, and support groups. FL treatment attributes related to efficacy, safety, and convenience were selected based on targeted literature review and clinical inputs. Patient preferences were assessed using conditional logistic regression models calculating the relative importance of and willingness to trade off treatment attributes.

The survey included 100 patients (median age: 61; 58.0% male), 82.0% of whom received ≥ 3 lines of therapy. All experienced ≥ 1 adverse event (AE). Patients preferred treatments with longer progression-free survival (PFS), less AE impact on quality of life (QoL), and oral administration (all p < .001). Treatment duration did not have a statistically significant impact. PFS was most important, followed by cytokine release syndrome (CRS) impact on QoL, mode of administration, rash and neurological event impact on QoL, travel time to access medication, and treatment duration. Treatment attributes in order of high to low relative importance to patients were PFS (26.8%), CRS impact on QoL (19.7%), mode of administration (15.8%), rash (14.6%) and neurological events' (14.2%) impact on QoL, and travel time to access medication (4.9%). Treatment duration (4.0%) was the least important attribute.

PFS had the greatest impact on treatment selection among patients with R/R FL, followed by the impact of CRS on QoL and the mode of administration. Patients were willing to trade some efficacy for improved safety and convenience, while treatment duration had minimal influence. Incorporating patient preferences may improve adherence and outcomes and warrants further evaluation.