PMID- 37041021 OWN - NLM STAT- MEDLINE DCOM- 20230413 LR - 20230430 IS - 2059-7908 (Print) IS - 2059-7908 (Electronic) IS - 2059-7908 (Linking) VI - 8 IP - 4 DP - 2023 Apr TI - Patient preferences for anti-hyperglycaemic medication for type 2 diabetes mellitus in China: findings from a national survey. LID - 10.1136/bmjgh-2022-010942 [doi] LID - e010942 AB - OBJECTIVE: This study aimed to investigate the preferences regarding risks, benefits and other treatment attributes of patients with type 2 diabetes mellitus (T2DM) in China when selecting a second-line anti-hyperglycaemic medicine. METHODS: A discrete choice experiment with hypothetical anti-hyperglycaemic medication profiles was performed using a face-to-face survey administered to patients with T2DM. The medication profile was described using seven attributes: treatment efficacy, hypoglycaemia risk, cardiovascular benefits, gastrointestinal (GI) adverse events, weight change, mode of administration and out-of-pocket cost. Participants chose between medication profiles by comparing attributes. Data were analysed using a mixed logit model with marginal willingness to pay (mWTP) and maximum acceptable risk (MAR) calculated. The preference heterogeneity within the sample was explored using a latent class model (LCM). RESULTS: A total of 3327 respondents from five major geographical regions completed the survey. Treatment efficacy, hypoglycaemia risk, cardiovascular benefits and GI adverse events were major concerns among the seven attributes measured. Weight change and mode of administration were of lesser concern. Regarding mWTP, respondents would pay yen236.1 (US$36.6) for an anti-hyperglycaemic medication with an efficacy of 2.5% points reduction in HbA1c, while they were willing to accept a weight gain of 3 kg only if they received a compensation of yen56.7 (US$8.8). Respondents were willing to accept a relatively large increase in hypoglycaemia risk (MAR=15.9%) to improve treatment efficacy from intermediate (1.0% points) to high (1.5% points). LCM identified the following four unobserved subgroups: trypanophobia, cardiovascular-benefits-focused, safety-focused and efficacy-focused and cost-sensitive. CONCLUSION: Patients with T2DM prioritised free out-of-pocket costs, highest efficacy, no hypoglycaemia risk and cardiovascular benefits over weight change and mode of administration. There exists great preference heterogeneity among patients, which should be taken into account in healthcare decision-making processes. CI - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Liu, Shimeng AU - Liu S AUID- ORCID: 0009-0007-6878-6272 AD - School of Public Health, Fudan University, Shanghai, China. AD - NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. FAU - Liu, Jing AU - Liu J AD - School of Management, Hainan Medical University, Haikou, Hainan, China. FAU - Si, Lei AU - Si L AUID- ORCID: 0000-0002-3044-170X AD - School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia. AD - Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia. FAU - Ke, Xiong AU - Ke X AD - School of Management, North Sichuan Medical College, Nanchong, Sichuan, China. FAU - Liu, Liu AU - Liu L AD - School of Public Health, Fudan University, Shanghai, China. AD - NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. FAU - Ren, Yanfeng AU - Ren Y AD - School of Public Health, Fudan University, Shanghai, China. AD - NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. FAU - Bao, Shiyi AU - Bao S AD - School of Public Health, Fudan University, Shanghai, China. AD - NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. FAU - Li, Fuming AU - Li F AD - School of Public Health, Fudan University, Shanghai, China. AD - NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. FAU - Yu, Yijiang AU - Yu Y AD - Department of Endocrinology, Huai'an Hospital of Traditional Chinese Medicine, Huaian, Jiangsu, China. FAU - Pan, Qi AU - Pan Q AD - Department of Endocrinology, Beijing Hospital, Beijing, China. FAU - Wei, Yan AU - Wei Y AD - School of Public Health, Fudan University, Shanghai, China yychen@shmu.edu.cn yanwei@fudan.edu.cn. AD - NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. FAU - Chen, Yingyao AU - Chen Y AUID- ORCID: 0000-0002-3470-0748 AD - School of Public Health, Fudan University, Shanghai, China yychen@shmu.edu.cn yanwei@fudan.edu.cn. AD - NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - BMJ Glob Health JT - BMJ global health JID - 101685275 RN - 0 (Hypoglycemic Agents) SB - IM MH - Humans MH - *Diabetes Mellitus, Type 2/chemically induced/drug therapy MH - Choice Behavior MH - Patient Preference MH - Surveys and Questionnaires MH - Hypoglycemic Agents/adverse effects PMC - PMC10106002 OTO - NOTNLM OT - Diabetes OT - Health economics OT - Health policy COIS- Competing interests: None declared. EDAT- 2023/04/12 06:00 MHDA- 2023/04/13 06:43 PMCR- 2023/04/11 CRDT- 2023/04/11 20:53 PHST- 2022/10/12 00:00 [received] PHST- 2023/03/09 00:00 [accepted] PHST- 2023/04/13 06:43 [medline] PHST- 2023/04/11 20:53 [entrez] PHST- 2023/04/12 06:00 [pubmed] PHST- 2023/04/11 00:00 [pmc-release] AID - bmjgh-2022-010942 [pii] AID - 10.1136/bmjgh-2022-010942 [doi] PST - ppublish SO - BMJ Glob Health. 2023 Apr;8(4):e010942. doi: 10.1136/bmjgh-2022-010942.