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. 2023 Jul-Dec;23(10):1117-1128.
doi: 10.1080/14737167.2023.2250916. Epub 2023 Aug 31.

Assessment of women's treatment preferences for vasomotor symptoms due to menopause

Aki Shiozawa  1 , Rebecca C Thurston  2 , Erin Cook  3 , Hongbo Yang  3 , Deanna D King  1 , Rita M Kristy  1 , Shayna Mancuso  1
Affiliations
Free article

Assessment of women's treatment preferences for vasomotor symptoms due to menopause

Aki Shiozawa et al. Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec.
Free article

Abstract

Background: Several therapies for vasomotor symptoms (VMS) due to menopause are available. Treatment preferences and willingness-to-pay for VMS treatment among US women with VMS were evaluated.

Methods: An online survey of women with perimenopausal or postmenopausal VMS was conducted (3/15/21-4/23/21). A discrete choice experiment quantified the impact of 7 treatment attributes on VMS treatment choice: VMS frequency/severity reduction, sleep improvement, risk of breast cancer/cardiovascular events in 6 years, risk of short-term side effects, and out-of-pocket costs. Preference weights (PWs) with 95% confidence intervals (CIs) were estimated and reported.

Results: Among 467 women, 86.5% and 87.8% reported moderate to very severe VMS and sleep problems during the preceding month, respectively. Sleep improvement (PW: 0.843; 95% CI: 0.721, 0.965) and reduction in VMS frequency (PW: 0.658; 95% CI: 0.520, 0.796) and severity (PW: 0.628; 95% CI: 0.500, 0.756) most influenced treatment preference; risk of cardiovascular events (PW: 0.150; 95% CI: 0.069, 0.232) or breast cancer (PW: 0.401; 95% CI: 0.306, 0.496) in 6 years had lesser effect. Willingness-to-pay was an additional $35-$46/month for substantially improved sleep, 80% VMS frequency reduction, and reduction from severe to mild VMS.

Conclusions: Sleep improvement and reductions in VMS frequency/severity were the most important treatment attributes.

Keywords: Discrete choice experiment; hormones; hot flashes; menopause; patient preference; questionnaires; surveys.

Plain language summary

Hormone and non-hormone treatments are available to reduce vasomotor symptoms (hot flashes and night sweats) due to menopause. We conducted an online survey of 467 women with moderate to very severe vasomotor symptoms during perimenopause or postmenopause to learn what treatment attributes are most important to women when selecting from among the available therapies and how much women were willing to pay for the attributes. Women were shown 14 cards, each with a side-by-side comparison of 2 treatments with varying descriptions of the following 7 treatment attributes: reduction in frequency of vasomotor symptoms, reduction in severity of vasomotor symptoms, improvement in sleep, risk of breast cancer in 6 years, risk of cardiovascular events in 6 years, risk of short-term side effects, and out-of-pocket costs. Women picked their preferred treatment on each card. Results showed that improvement in sleep was the most important attribute to women, and they were willing to pay an extra $46/month for a treatment that substantially improved sleep. The next most important attributes were reduction in frequency and reduction in severity of vasomotor symptoms. Women were willing to pay $36/month more for a treatment that reduced symptom frequency by 80% compared with one that reduced frequency by 50%, and they were willing to pay $35/month more for treatment that reduced symptoms from severe to mild compared with one that did not reduce symptom severity. These results may help guide development of new treatment options and may help physicians recommend treatments that best fit women’s preferences.

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