Patient preferences for pharmacological treatments for obesity: The VOICE study

Background: With the emergence of new pharmacological treatments for obesity, understanding patient preferences for different medication attributes is important for shared decision-making conversations. The purpose of this study was to evaluate preferences for specific obesity medication (OM) attributes. Methods: This was a cross-sectional online survey study. Adults living with Class I/II obesity or overweight with a comorbidity were recruited to complete a discrete choice experiment (DCE) and questions on willingness to inject OMs. The DCE included attributes for mode/frequency of administration, food/water restrictions, and storage requirements. A mixed logit model was used to calculate the relative attribute importance (RAI). Results: A total of 351 participants completed the study. When asked about their willingness to inject OMs, 25.4% of participants were unwilling to use weekly injections, and 17.7% were unwilling to use monthly injections. Mode/frequency of administration was the most important characteristic (RAI: 62.7%), followed by food/water restrictions (RAI: 21.2%), and storage (RAI: 16.1%). In the context of a treatment choice where weight loss and side effects were explicitly defined as equal across the options presented, a once-daily pill was significantly more preferred to a once-weekly injection (p < 0.001). Conclusions: Approximately one in four participants were unwilling to take a weekly injectable OM and significantly preferred daily oral medication. These results suggest opportunities to better align treatment attributes with patient preferences and the need to consider all aspects of OMs beyond efficacy and safety during shared decision-making.