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Defining the needs and preferences of patients with dry eye disease
  1. Penny Asbell1,
  2. Elisabeth Messmer2,
  3. Colin Chan3,
  4. Gary Johnson4,
  5. Brigitte Sloesen5,
  6. Nigel Cook5
  1. 1Ophthalmology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  2. 2Department of Ophthalmology, Ludwig Maximilians University, Munich, Germany
  3. 3Central Clinical School, University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia
  4. 4Inpharmation, High Wycombe, UK
  5. 5Global Patient Access, Novartis Pharma, Basel, Switzerland
  1. Correspondence to Dr Nigel Cook; nigel.cook{at}


Objective Dry eye disease is a multifactorial chronic disease, leading to ocular discomfort and visual disturbance with a substantial impact on quality of life. Therefore, the patient’s perspective should be taken into account early in the drug development process. We have developed a step-by-step methodology based on the self-explicated conjoint approach to assess the needs and preferences of patients with moderate-to-severe dry eye disease.

Methods and Analysis Following a literature review and social media listening (step 0), qualitative phone call interviews were conducted with 12 patients (step 1). Patients’ responses underwent content analysis and were coded, quantified and displayed as charts. Based on the emerging trends and attributes identified as relevant in steps 0 and 1, a quantitative online questionnaire was designed and conducted with 160 patients across four countries (step 2).

Results The online questionnaire was rated as easy/very easy to understand by 60% of respondents, 62% rated the survey as easy/very easy to complete and 71% rated it as interesting/very interesting. Treatment satisfaction was the most important aspect for patients, and the three most relevant attributes were as follows (with the most important indexed to 100%): ‘treatment effectiveness on symptoms of dry eyes’ (100%), ‘frequency of treatment use’ (96%) and ‘how the treatment works’ (95%).

Conclusion Our methodology was well received by patients, and the results will help inform future clinical trial development and discussions with health technology assessment bodies and regulators on unmet needs and product attributes that are of most value to patients with dry eye disease.

  • ocular surface
  • pharmacology
  • public health
  • tears
  • treatment medical

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  • Presented at These results have been presented as a poster at the HTAi Congress, Vancouver, 2 June 2018.

  • Contributors All authors contributed to the development of the study concept, and data analysis and interpretation. With regard to the design of this study, the authors were consulted by the Deutscher Blinden und Sehbehindertenverband eV (DBSV) as regulated by a contract between Novartis and DBSV. All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article and take responsibility for the integrity of the work as a whole. All authors were involved in the preparation and review of the manuscript and approved the final version to be submitted.

  • Funding The funding/sponsorship of this study and article processing charges were funded by Novartis Pharma, Basel, Switzerland.

  • Competing interests PA has received research funding from Alcon and MC2 Therapeutics and has participated in the advisory boards of Alcon/Novartis, Allergan and Shire. EM: consultant for Dompe, Pharm Allergan, Santen and Thea, and lecturer for Alcon, Dompe, Pharm Allergan, Santen, Thea and Ursapharm. CC: consultant for Alcon and has participated in the advisory boards of Alcon/Novartis. NC and BS are employees of Novartis. In addition, NC is a member of IMI PREFER and is also involved with the working groups of ISPOR and HTAi on patient preferences. GJ is an employee of Inpharmation.

  • Patient consent for publication Obtained.

  • Ethics approval Our study obtained approval from the Heartland Institutional Review Board, and the research conformed to the codes of both BHBIA (British Healthcare Business Intelligence Association) and EphMRA (European Pharmaceutical Market Research Association). These codes of conduct stop this type of research being used as a front for marketing activities and ensure that all adverse event procedures are properly adhered to. Patient cooperation was voluntary, and they were entitled to withdraw at any stage of the process, or subsequently to ask that part or all of the record of their interview was destroyed or deleted. All patients received financial compensation at fair market value in line with the country regulations for their voluntary participation in the survey. The patients were advised that the information they provided would be treated confidentially, without reference to individual names. They were assured that any information they gave would simply be added to the answers received from other respondents to provide an overall picture of views, which may be used in a scientific publication. The online survey was run via a secure website, with data access strictly limited to the patient and the survey support team. Adequate data protection statements were also included.

  • Provenance and peer review Not commissioned; externally peer reviewed.