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Candice Yong,1 M Janelle Cambron-Mellott,2 Brian Seal,1 Oliver Will,2 Martine C Maculaitis,2 Kelly Clapp,2 Emily Mulvihill,2 Ion Cotarla,1 Ranee Mehra3 1AstraZeneca, Gaithersburg, MD, USA; 2Cerner Enviza, Malvern, PA, USA; 3University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD, USACorrespondence: M Janelle Cambron-MellottCerner Enviza, 51 Valley Stream Pkwy, Malvern, PA, 19355, USATel +1 816 201 2190Email Janelle.CambronMellott@cernerenviza.comPurpose: The approval of immune checkpoint inhibitors for metastatic non-small-cell lung carcinomas (mNSCLC) treatment has presented more care options. Therefore, it is important to identify the benefit-risk trade-offs patients and caregivers are willing to make among potential treatment options. This study quantified the preferences of patients and caregivers for attributes of mNSCLC treatment.Methods: Patients with mNSCLC and caregivers completed an online survey assessing preferences using a discrete choice experiment. Respondents chose between hypothetical treatment profiles, with varying levels for 7 attributes associated with first-line treatment, including overall survival (OS), progression-free survival, select adverse events (AEs), and regimen (caregivers). Hierarchical Bayesian modeling was used to estimate attribute-level preference weights.Results: Patients (n = 308) and caregivers (n = 166) most valued increasing OS from 11 to 30 months, followed by decreasing the risk of a serious AE (grade 3/4) that may lead to hospitalization from 70% to 18%. These attributes were over twice as important to both sets of respondents as the other attributes measured. Patients and caregivers would accept increases in the risks of a serious AE (grade 3/4) from 18% to 70% and all grades nausea from 10% to 69% if OS increased by 16.8 and 4.0 months, respectively. The least valued attributes were all grades of pneumonitis (patients) and all grades of skin rash (caregivers).Conclusion: Patients and caregivers are willing to make trade-offs between efficacy and toxicity and may require up to 1.5 years of increased OS to accept a higher risk of AEs. These results can provide guidance to oncologists when engaging in shared-decision making discussions.Keywords: immune checkpoint inhibitors, metastases, non-small-cell lung carcinomas, overall survival, patient preference, toxicities

Additional file 1: Table S1. Parameter estimates for the models run. Table S2. Parameter estimates for linear spline regression model: estimation sample. Table S3. Fit statistics of estimation sample: overall and by EQ-5D quartile. Table S4. Slope estimates for piecewise linear regression model with breakpoint of ESS score 11.00: estimation sample. Figure S1. Observed versus predicted EQ-5D utility: estimation sample EQ-5D: EuroQoL- 5 Dimensions. Figure S2. Residual plot for observed versus predicated EQ-5D utility: estimation sample EQ-5D: EuroQoL- 5 Dimensions

M Janelle Cambron-Mellott,1 Jaromir Mikl,2 Joana E Matos,1 Jennifer G Erensen,2 Kathleen Beusterien,1 Marc J Cataldo,2 Bernadette Hallissey,1 Gregory W Mattingly3– 5 1Kantar Health, New York, NY, USA; 2Purdue Pharma L.P./Adlon Therapeutics, L.P., Stamford, CT, USA; 3Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; 4Midwest Research Group, St. Charles, MO, USA; 5St. Charles Psychiatric Associates, St. Charles, MO, USACorrespondence: M Janelle Cambron-MellottKantar Health, 3 World Trade Center, 175 Greenwich Street, 35th Floor, New York, NY, 10007, USATel +1 212 706 3961Email janelle.cambron-mellott@kantar.comBackground and Objective: Treatment for attention deficit hyperactivity disorder (ADHD) requires a multifaceted approach including psychosocial interventions and pharmacological treatment. This study evaluates preferences for specific attributes associated with different long-acting stimulant treatment among US adults with ADHD.Methods: Patients completed an online, cross-sectional survey, incorporating a discrete choice experiment to assess preferences for attributes.Results: Analyses included 200 adults with ADHD (mean age 33.0 years; 60% self-reporting moderate severity); the mean (SD) Adult ADHD Self-Report Scale-v1.1 score was 45.9 (12.4). Overall, patients valued speed of onset most and risk of rebound least. Three population groups with distinct preferences were identified: side effect-driven (n=69, 35%), quick onset-driven (n=47, 24%) and quick onset and long duration-driven (n=84, 42%).Conclusion: This study shows differences in how adults with ADHD value and assess benefit-risk trade-offs when considering the desired attributes of stimulant treatments, highlighting the importance of patient-physician shared decision-making to optimize the desired benefits of individualized treatment.Keywords: attention deficit hyperactivity disorder, choice behavior, CNS stimulants, discrete choice experiment, patient preference

To evaluate and compare patient and neurologist preferences for relapsing-remitting multiple sclerosis (RRMS) treatments with respect to benefits and risks associated with common and novel disease-modifying therapies, including brain volume loss (BVL). Methods: Patients with non–highly active RRMS and neurologists in the United Kingdom completed an online cross-sectional survey. Patients completed one discrete choice experiment (DCE) exercise and providers completed two, one focusing on treatment for non–highly active RRMS, and another focused on highly active RRMS. Respondents chose between two treatment profiles that varied on 7 attributes identified in qualitative research: 2-year disability progression; 1-year relapse rate; rate of BVL; and risks of gastrointestinal symptoms, flu-like symptoms, infection, and life-threatening event. Bayesian modelling was used to estimate attribute-level weighted preferences. Results: Patients (n = 144) prioritized slowing the rate of BVL, followed by reducing risk of infection, rate of 2-year disability progression, and 1-year relapse rate. For non–highly active patients, neurologists (n = 101) prioritized slowing the rate of BVL, followed by reducing 2-year disability progression, risk of infection, and 1-year relapse rate. For highly active patients, neurologists prioritized lowering the 1-year relapse rate, followed by slowing the rate of BVL and 2-year disability progression. In all 3 DCEs, rate of BVL was approximately twice as important as reducing the risks of flu-like symptoms, gastrointestinal symptoms, and life-threatening event. Conclusions: This study highlights similarities in treatment preferences for non–highly active RRMS among patients and neurologists and differences in neurologists’ preferences for treating non–highly active vs. highly active RRMS. This research identifies BVL as a treatment outcome that should be discussed when physicians engage in shared decision-making with patients.