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

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. 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. Participants were adolescents (<i>n</i> = 73, mean age 15.9 years) and caregivers (<i>n</i> = 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 <i>versus</i> no reduction (<i>p</i> &lt; 0.001); oral administration over subcutaneous (<i>p</i> &lt; 0.001); administration in a home <i>versus</i> clinical setting (<i>p</i> &lt; 0.05); less frequent <i>versus</i> daily administration (every two weeks: <i>p</i> &lt; 0.001; every four weeks: <i>p</i> &lt; 0.001). Respondents were disinclined to prefer treatment attributes when the risk of gastrointestinal symptoms (<i>p</i> &lt; 0.001) or anaphylaxis (<i>p</i> &lt; 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)]. 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.