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August 16, 2016
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INSIGHTEC is conducting research that helps us better understand patients, their motivations and concerns regarding their medical condition and available treatments.

This post looks into qualitative research which was conducted through focus groups in China, among women who are uterine fibroids patients. Here are some of the topics that were discussed and the insights we discovered.


Discovering you have uterine fibroids

In China, company-organized health checks are happening on a regular basis and this is where most women get their first diagnosis.

Most patients who participated already knew what uterine fibroids were when they were first diagnosed, mostly because they know other women who have them. They were not necessarily aware of what they are exactly, a benign tumor.

Participants were asked about feeling ashamed and their openness to discuss the condition. Some said they have no problem discussing it with friends (especially female ones), their spouse, or colleagues. Others on the other hand, were more inclined to conceal their condition, mainly from parents, as not to cause them any concern.


Main concerns about uterine fibroids

When women discover that they have uterine fibroids there are several concerns that come to mind.

  • How do uterine fibroids affect fertility?
  • Can fibroids develop into cancer?
  • Are there any birth related risks (birth canal obstruction, fetal oppression–induced premature delivery)?


Selecting a treatment - the decision making process

There are several treatment methods for uterine fibroids. From fully invasive hysterectomy to micro-invasive treatments and non-invasive treatments such as MRgFUS.

In China, the non-invasive MRgFUS treatment has not been extensively used. That makes patients a bit more hesitant to select it as their treatment of choice over more widely known treatment options.

Yet, for a variety of reasons, many patients are seeking a non-invasive treatment option because they are unable to go through a surgical procedure. Some women are allergic to anesthetics while others would like to avoid invasive operations at all costs.


Specific concerns regarding the MRgFUS treatment

Although the treatment is non-invasive, there are still some specific concerns when considering the treatment. Most of these concerns can easily be addressed by providing appropriate communication and full information about the treatment:

Treatment Safety:

  • Is the technology safe? Can the skin and uterus tolerate the focused energy?
  • Does the treatment impact other organs or tissue?
  • Is it approved by regulatory bodies, such as the FDA?
  • How many times has the technology been used on similar cases, successfully?
  • How experienced is the treating physician with this specific technology?

Treatment Effectiveness:

  • Can the treatment completely eliminate the fibroid(s) once and for all?
  • Can fibroid(s) return post procedure?
  • How can one know if the fibroid is benign or malignant?
  • What happens to the ablated fibroid tissue that stays in the uterus?

Treatment costs

When asked about the ability and willingness to pay for the treatment, most interviewees didn’t consider it a main factor in the decision making process. They indicated they can absolutely afford such a safe and effective non-invasive method, even if it is not covered by medical insurance. But medical insurance becomes more critical when looking at treatment costs beyond the initial, one-time treatment. Patients were concerned that multiple treatments can get relatively expensive, especially in the case of reoccurrence.


Factors that women mentioned which would make MRgFUS as a viable treatment option:

  • Its success rate
  • If it is really effective and fibroids are not expected to return
  • Knowing that it is a clinically-backed technology with minimal risks
  • There is very little pain involved with quick recovery time
  • It’s non-invasive and does not leave an ugly scar
  • The fact that it doesn’t affect future pregnancies


Information sources used in the treatment selection decision making process

In today’s information sharing era, women look at several sources before deciding on a treatment.

Here are a few information sources and related attitudes that were mentioned.

Reliable sources

  • Advice from professional authoritative doctors (specialists, doctors at outpatient clinics of 3 A level hospitals)
  • Domestic of foreign medical literature (indicated by women who are more familiar with the medical field)

Independent research

  • Friends (online and WeChat friends included)
  • Online research: (1) Uterine fibroids or health related official websites / channels & (2)Self-initiated uterine fibroids patient groups

Suspicious sources

  • Medical adverts
  • Telemarketing calls


Summary: Chinese market insights go global

According to the focus groups, MRgFUS treatment of uterine fibroids is more crucial for women who are delaying childbearing and women at a late reproductive age who are considering having a second child.

Due to the limitation of labeling in CFDA, these women should indeed be the key target patients of MRgFUS, as they are often more financially stable (capable of raising a second child), and therefore are more likely to be able to afford the MRgFUS treatment.

Also, these women have an urgent desire to get pregnant. Therefore, the fact that MRgFUS can immediately improve their chances to conceive is appealing to them.

Although these insights were derived from focus groups in China, they present an interesting targeting case for medical facilities in other countries as well.

Focus group objectives and methodology (reference)

  • In case you are interested in some background information about the research:
  • The research was conducted in order to identify cultural-social-psychological factors that are influencing patient choice regarding MRgFUS, as well as identifying key target patients for the MRgFUS treatment.
  • The research aimed at listing the optimal go-to sources and messages for patient-oriented dissemination of information, and the type of information that would be most effective in influencing the treatment selection decision process.
  • The research was performed via focus group interviews.
  • Interviewees were uterine fibroid patients aged 25-45 years who are actively seeking for treatment, being treated, or have been treated successfully within the last two years.
  • All interviewees had a monthly household income greater than RMB10,000 (greater than RMB15,000 in Beijing and Shanghai)
  • All interviewees have been living for a long time in Beijing, Harbin, Shanghai, and surrounding cities of Shanghai.
  • There were a total of 33 interviewees in all three cities. 

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