Patient preferences for attributes of type 2 diabetes mellitus (T2dm) treatments in Spain

Abstract

Objectives Understanding the preferences for attributes of T2DM treatments among patients in Spain. Methods Patients in Spain (self-reported physician diagnosis of T2DM, taking a prescription T2DM medication for > 2 years) completed an online discrete-choice experiment (DCE) survey (funded by GSK) to elicit preferences for T2DM treatment attributes. Respondents chose between pairs of hypothetical T2DM treatments defined by seven attributes: chance of reaching target HbA1c, reduction in risk of serious heart attack or stroke, frequency of hypoglycemia, risk of gastrointestinal (GI) problems, weight change, mode of administration, and dosing frequency. Random-parameters logit (RPL) was used to analyze the data. Minimum acceptable benefit (MAB) was calculated with RPL coefficients and measures the percentage point (pp) increase in the probability of reaching target HbA1c that respondents require in order to accept worse levels of other attributes. Results 401 patients responded (mean age 51, 77% male, 33% diagnosed more than 7 years ago). The DCE respondents preferred pills to injections and once-weekly dosing over other schedules. The highest MAB levels were: moving from pill to injection (MAB=59pp), moving from once-weekly dosing frequency to more than twice a day (MAB=40pp), moving from no risk of GI problems to 30% risk of GI problems (MAB=37pp), moving from no hypos to more than 2 hypos per month (MAB=37pp), and moving from a 2-kg weight loss to a 2-kg weight gain (MAB=35pp). Respondents using injectables were indifferent between pills and injections, while respondents not using injectables had a strong preference for pills over injections (P = 0.00). Conclusions Respondents were willing to trade-off efficacy for an improvement in mode of administration (from injection to pills) and improved side effects . Given the variety of T2DM medications available, the results suggest that careful discussion about patient preferences could help improve patient satisfaction with T2DM drugs.