Physician preferences for extra-glycemic effects of type 2 diabetes treatments

Abstract

Introduction
The purpose of this study was to quantify United States (US) and United Kingdom (UK) physicians’ preferences for attributes of type 2 diabetes treatments.
Methods
Samples of general practitioners (GPs) and endocrinologists in the US (n = 204) and the UK (n = 200) completed a discrete-choice experiment in which respondents chose between pairs of hypothetical type 2 diabetes treatments in a series of trade-off questions. The questions described hypothetical injectable treatments with differing levels of attributes, such as glucose control and treatment side effects. Relative importance of attributes was estimated by a multivariate regression model for limited dependent variables. These results were used to calculate how the predicted probability of choosing hypothetical type 2 diabetes treatments varies with changes in given attributes.
Results
The most important attributes to physicians were glucose control, risk of a fatal myocardial infarction (MI), and weight change. For US physicians, glucose control was about twice as important as gastrointestinal side effects, 5 times more important than changes in depression symptoms, and 20 times more important than liver monitoring. For UK physicians, reduction in MI risk was about 1.5 times more important than glucose control, 2.5 times more important than gastrointestinal side effects, and 10 times more important than liver-monitoring requirements. Preferences were similar among physicians in the US and the UK and among GPs and endocrinologists.
Conclusions
Physicians valued type 2 diabetes treatments that go beyond glycemic control, although mitigating different complications and comorbidities was not equally as important.