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Utilities and disutilities for type 2 diabetes treatment-related attributes

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Abstract

Introduction

Although cost-utility analyses are frequently used to estimate treatment outcomes for type 2 diabetes, utilities are not available for key medication-related attributes. The purpose of this study was to identify the utility or disutility of diabetes medication-related attributes (weight change, gastrointestinal side effects, fear of hypoglycemia) that may influence patient preference.

Methods

Patients with type 2 diabetes in Scotland and England completed standard gamble (SG) interviews to assess utility of hypothetical health states and their own current health state. The EQ-5D, PGWB, and Appraisal of Diabetes Symptoms were administered. Construct validity and differences among health states were examined with correlations, t-tests, and ANOVAs.

Results

A total of 129 patients (51 Scotland; 78 England) completed interviews. Mean utility of diabetes without complications was 0.89. Greater body weight was associated with disutility, and lower body weight with added utility (e.g., 3% higher = −0.04; 3% lower = +0.02). Gastrointestinal side effects and fear of hypoglycemia were associated with significant disutility (p < 0.001). SG utility of current health (mean = 0.87) demonstrated construct validity through correlations with patient-reported outcome measures (r = 0.08–0.31).

Discussion

The vignette-based approach was feasible and useful for assessing added utility or disutility of medication-related attributes.

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Acknowledgements

The authors would like to thank Karen Malley for thoughtful statistical programming and Shay Almaroof for production assistance. We would also like to thank Drs. Robert Brodows, Michael Trautmann, Andreas Festa, and Dennis Revicki for expert consultation. Permission to use all patient-reported outcome measures was granted by the instrument developers. This study was funded by Eli Lilly and Company.

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Matza, L.S., Boye, K.S., Yurgin, N. et al. Utilities and disutilities for type 2 diabetes treatment-related attributes. Qual Life Res 16, 1251–1265 (2007). https://doi.org/10.1007/s11136-007-9226-0

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  • DOI: https://doi.org/10.1007/s11136-007-9226-0

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