Patient preferences for food allergy treatments in the United States: a discrete choice experiment.

Abstract

Objective: To estimate preferences of adolescents and caregivers of children with food allergies (FA) for food allergy for attributes for treatments intended to prevent exposure-induced severe reactions and to examine how these vary by clinical and demographic factors.

Methods: A discrete choice experiment (DCE) was conducted between May and June 2024 among US-resident individuals, aged 13-17 years or caregivers of a child with FA aged ≤12 years, self-reporting physician-diagnosed FA. The survey comprised treatment-attribute focused DCE choice sets; the Intolerance of Uncertainty-12 Scale (IUS-12); the Food Allergy Independent Measure (FAIM); and clinical/demographic questions. Conditional logistic regression analyses were conducted overall and among subgroups and presented as odds ratios (ORs) with 95% confidence intervals (CIs). Relative importance of attributes was also calculated.

Results: Participants were adolescents (n = 73, mean age 15.9 years) and caregivers (n = 228, mean age 37.1 years). Overall, treatment attributes associated with statistically significant odds for preferring a treatment included a 95% relative reduction in moderate-to-severe allergic reaction risk versus no reduction (p < 0.001); oral administration over subcutaneous (p < 0.001); administration in a home versus clinical setting (p < 0.05); less frequent versus daily administration (every two weeks: p < 0.001; every four weeks: p < 0.001). Respondents were disinclined to prefer treatment attributes when the risk of gastrointestinal symptoms (p < 0.001) or anaphylaxis (p < 0.001) increased. Efficacy (75% decrease in relative risk of a moderate-to-severe allergic reaction) was the top ranked attribute [OR = 1.61 (1.49, 1.75)].

Conclusion: Overall, respondents indicated significant preferences for more efficacious, safer, and convenient (oral, at-home, and less frequent) treatments. Treatment efficacy was the most highly ranked treatment feature.