PMID- 30165844
OWN - NLM
STAT- MEDLINE
DCOM- 20181115
LR  - 20190318
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 18
IP  - 1
DP  - 2018 Aug 30
TI  - Valuing injection frequency and other attributes of type 2 diabetes treatments in 
      Australia: a discrete choice experiment.
PG  - 675
LID - 10.1186/s12913-018-3484-0 [doi]
LID - 675
AB  - BACKGROUND: Multiple pharmacotherapy options are available to control blood 
      glucose in Type 2 Diabetes Mellitus (T2DM). Patients and prescribers may have 
      different preferences for T2DM treatment attributes, such as mode and frequency 
      of administration, based on their experiences and beliefs which may impact 
      adherence. As adherence is a pivotal issue in diabetes therapy, it is important 
      to understand what patients value and how they trade-off the risks and benefits 
      of new treatments. This study aims to investigate the key drivers of choice for 
      T2DM treatments, with a focus on injection frequency, and explore patients' 
      associated willingness-to-pay. METHODS: A discrete choice experiment (DCE) was 
      used to present patients with a series of trade-offs between different treatment 
      options, injectable and oral medicines that were made up of 10 differing levels 
      of attributes (frequency and mode of administration, weight change, needle type, 
      storage, nausea, injection site reactions, hypoglycaemic events, instructions 
      with food and cost). A sample of 171 Australian consenting adult T2DM patients, 
      of which 58 were receiving twice-daily injections of exenatide and 113 were on 
      oral glucose-lowering treatments, completed the national online survey. An error 
      components model was used to estimate the relative priority and key drivers of 
      choice patients place on different attributes and to estimate their willingness 
      to pay for new treatments. RESULTS: Injection frequency, weight change, and 
      nausea were shown to be important attributes for patients receiving injections. 
      Within this cohort, a once-weekly injection generated an additional benefit over 
      a twice-daily injection, equivalent to a weighted total willingness to pay of 
      AUD$22.35 per month. CONCLUSIONS: Based on the patient preferences, the 
      importance of frequency of administration and other non-health benefits can be 
      valued. Understanding patient preferences has an important role in health 
      technology assessment, as the identification of the value as well as the 
      importance weighting for each treatment attribute may assist with funding 
      decisions beyond clinical trial outcomes.
FAU - Fifer, Simon
AU  - Fifer S
AD  - Community and Patient Preference Research (CaPPRe), Level 5, 478 George St, 
      Sydney, NSW, 2000, Australia. simon.fifer@cappre.com.au.
AD  - Community and Patient Preference Research Pty Ltd, PO Box 1156, Darlinghurst, 
      NSW, 1300, Australia. simon.fifer@cappre.com.au.
FAU - Rose, John
AU  - Rose J
AD  - Business Intelligence & Data Analytics (BIDA) Research Centre, University of 
      Technology of Sydney, Ultimo, NSW, 2007, Australia.
FAU - Hamrosi, Kim K
AU  - Hamrosi KK
AD  - Community and Patient Preference Research (CaPPRe), Level 5, 478 George St, 
      Sydney, NSW, 2000, Australia.
FAU - Swain, Dan
AU  - Swain D
AD  - Swain Health Economics, 15 Tidal Cr, Moonee Beach, Coffs Harbour, NSW, 2450, 
      Australia.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20180830
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Peptides)
RN  - 0 (Venoms)
RN  - 9P1872D4OL (Exenatide)
SB  - IM
MH  - Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Australia
MH  - Blood Glucose/metabolism
MH  - Choice Behavior
MH  - Clinical Decision-Making
MH  - Diabetes Mellitus, Type 2/*drug therapy/economics
MH  - Drug Administration Schedule
MH  - Exenatide
MH  - Female
MH  - Financing, Personal
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage/economics/therapeutic use
MH  - Injections
MH  - Male
MH  - Middle Aged
MH  - Patient Preference/statistics & numerical data
MH  - Peptides/*administration & dosage/economics
MH  - Pilot Projects
MH  - Venoms/*administration & dosage/economics
MH  - Young Adult
PMC - PMC6117901
OTO - NOTNLM
OT  - Consumer surplus
OT  - Diabetes
OT  - Discrete choice experiment
OT  - Health technology assessment
OT  - Patient preference
OT  - Reimbursement
OT  - Willingness to pay
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethics: The study was conducted under 
      the Australian Market and Social Research Society (AMSRS) Code of Professional 
      Behaviour which covered the ethical requirements and standard conditions of 
      conducting and reporting market and social research. Patient involvement and 
      consent: The development of the research question and design of the study is 
      based on the creating real life treatment decisions patients pay face when 
      selecting between treatments. The content and associated attributes used in the 
      DCE study was informed by initial qualitative research with patients and a review 
      of patient literature, however no direct patient input was used in finalising the 
      included attributes. This information provided context to the study to firstly 
      better understand patient' priorities, experiences and preferences for treatment 
      with type 2 diabetes and secondly ensure that the relevant attributes of 
      treatment were included in the DCE. A pilot was conducted with patients and 
      feedback received. Revisions were consequently made to the study design and 
      content. All patients were asked to provide consent to participate by selecting 
      an option in the online survey. To be able to ensure the results of the study are 
      available to anyone, particularly patients, who are interested in knowing more 
      about preferences for treatment of type 2 diabetes we are electing to submit to a 
      journal with open access. CONSENT FOR PUBLICATION: Not applicable. COMPETING 
      INTERESTS: DS was an employee of AstraZeneca at the time of the study. 
      PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional 
      claims in published maps and institutional affiliations.
EDAT- 2018/09/01 06:00
MHDA- 2018/11/16 06:00
PMCR- 2018/08/30
CRDT- 2018/09/01 06:00
PHST- 2018/04/16 00:00 [received]
PHST- 2018/08/20 00:00 [accepted]
PHST- 2018/09/01 06:00 [entrez]
PHST- 2018/09/01 06:00 [pubmed]
PHST- 2018/11/16 06:00 [medline]
PHST- 2018/08/30 00:00 [pmc-release]
AID - 10.1186/s12913-018-3484-0 [pii]
AID - 3484 [pii]
AID - 10.1186/s12913-018-3484-0 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2018 Aug 30;18(1):675. doi: 10.1186/s12913-018-3484-0.