Patients' and physicians' preferences for type 2 diabetes mellitus treatments in Spain and Portugal : a discrete choice experiment
Morillas, Carlos (Hospital Universitari Doctor Peset (València))
Feliciano, Rosa (USF São Domingos, Santarém, Portugal)
Catalina, Pablo Fernández (Hospital Montecelo de Pontevedra)
Ponte, Carla (USF Porta do Sol)
Botella, Marta (Hospital Universitario Príncipe de Asturias (Alcalá de Henares, Madrid))
Rodrigues, João (USF Serra da Lousã)
Esmatjes, Enric (Hospital Clínic i Provincial de Barcelona)
Lafita, Javier (Complejo Hospitalario de Navarra)
Lizán, Luis (Outcomes'10, Universidad Jaume I, Castellón, Spain)
Llorente, Ignacio (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Morales, Cristóbal (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Navarro-Pérez, Jorge (Hospital Clínic Universitari (València))
Orozco-Beltrán, Domingo (Sociedad Española de Medicina Familiar y Comunitaria, Valencia, Spain)
Paz, Silvia (Outcomes'10, Universidad Jaume I, Castellón, Spain)
Ramirez de Arellano, Antonio (Novo Nordisk EU-HEOR Europe, Madrid, Spain)
Cardoso, Cristina (Novo Nordisk, Lisbon, Portugal)
Tribaldos Causadias, Maribel (Outcomes'10, Universidad Jaume I, Castellón, Spain)

Date:	2015
Abstract:	To assess Spanish and Portuguese patients' and physicians' preferences regarding type 2 diabetes mellitus (T2DM) treatments and the monthly willingness to pay (WTP) to gain benefits or avoid side effects. An observational, multicenter, exploratory study focused on routine clinical practice in Spain and Portugal. Physicians were recruited from multiple hospitals and outpatient clinics, while patients were recruited from eleven centers operating in the public health care system in different autonomous communities in Spain and Portugal. Preferences were measured via a discrete choice experiment by rating multiple T2DM medication attributes. Data were analyzed using the conditional logit model. Three-hundred and thirty (n=330) patients (49. 7% female; mean age 62. 4 [SD: 10. 3] years, mean T2DM duration 13. 9 [8. 2] years, mean body mass index 32. 5 [6. 8] kg/m 2, 41. 8% received oral + injected medication, 40. 3% received oral, and 17. 6% injected treatments) and 221 physicians from Spain and Portugal (62% female; mean age 41. 9 [SD: 10. 5] years, 33. 5% endocrinologists, 66. 5% primary-care doctors) participated. Patients valued avoiding a gain in bodyweight of 3 kg/6 months (WTP: €68. 14 [95% confidence interval: 54. 55-85. 08]) the most, followed by avoiding one hypoglycemic event/month (WTP: €54. 80 [23. 29-82. 26]). Physicians valued avoiding one hypoglycemia/week (WTP: €287. 18 [95% confidence interval: 160. 31-1,387. 21]) the most, followed by avoiding a 3 kg/6 months gain in bodyweight and decreasing cardiovascular risk (WTP: €166. 87 [88. 63-843. 09] and €154. 30 [98. 13-434. 19], respectively). Physicians and patients were willing to pay €125. 92 (73. 30-622. 75) and €24. 28 (18. 41-30. 31), respectively, to avoid a 1% increase in glycated hemoglobin, and €143. 30 (73. 39-543. 62) and €42. 74 (23. 89-61. 77) to avoid nausea. Both patients and physicians in Spain and Portugal are willing to pay for the health benefits associated with improved diabetes treatment, the most important being to avoid hypoglycemia and gaining weight. Decreased cardiovascular risk and weight reduction became the third most valued attributes for physicians and patients, respectively.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Diabetes ; Discrete choice model ; Preferences ; Willingness to pay ; Hypoglycemia ; Weight ; Cardiovascular risk ; HbA
Published in:	Patient preference and adherence, Vol. 9 (october 2015) , p. 1443-1458, ISSN 1177-889X

DOI: 10.2147/PPA.S88022
PMID: 26508841

16 p, 798.6 KB

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