Piloting a discrete choice experiment-style task to elicit treatment preferences in Geographic Atrophy

Abstract Objective: Geographic Atrophy (GA) is the advanced form of the non-neovascular (‘dry’) type of age-related macular degeneration (AMD) and responsible for one-quarter of legal blindness in the UK. While no approved treatment for GA currently exists, new therapies delivered by intravitreal injection are in late-stage development. These therapies slow down, but do not stop or reverse, progression of GA, but may also increase the risk of developing the neovascular (‘wet’) type of AMD. Within a larger study exploring the acceptability of these new treatments to people living with GA, we developed a discrete choice experiment (DCE)-style exercise to evaluate how participants weigh up benefits and drawbacks of different treatment regimens. This research note reports quantitative and qualitative findings from this exercise. Results: Twenty-eight participants took part in this DCE-style exercise. The exercise demonstrated that participants were generally, although not unanimously, in favour of less frequent treatment for GA that was slightly less efficacious in terms of preserving visual function but presented a lower risk of developing wet AMD . Even among a small sample, the exercise demonstrated the highly personal and idiosyncratic decision-making processes influencing participants’ choices of preferred hypothetical GA treatment.