Disease burden and treatment preference for moderate-to-severe atopic dermatitis in Taiwan: A discrete-choice experiment

This study aimed to elicit the preferred treatment attributes of patients with atopic dermatitis (AD) and caregivers, and their willingness to pay based on preferred treatment attributes in Taiwan. A cross-sectional, self-administered, online survey study in Taiwan was conducted between March 2022 and July 2023 among adult AD patients (aged >20 years) (n = 40) and caregivers of teenage AD patients (aged 12–19 years) (n = 10). Survey items included disease burden, out-of-pocket costs, willingness to pay, and assessment of treatment attributes using discrete-choice experiment. Hierarchical Bayesian logistic regression was used to quantify preferences and the relative importance of the attributes. Most responders (88%) rated ≤40 in a 100-scale questionnaire regarding quality-of-lfe due to AD without effective treatment. “Probability of skin clearance” was the most important attribute while choosing advanced AD therapy, followed by “Probability of itch reduction”, “Risk of severe side effects”, “Route and frequency of administration”, and “Time-to-onset of itch relief”. The proportion of unwillingness to pay decreased from 14.7% to 2.9% with reducing time-to-onset of itch relief and increasing skin clearance probability. Patients with AD and caregivers valued treatment benefits the most and were willing to accept an increase in severe side effects for increased probability of skin clearance and itch reduction.