Health Utility Decrement of Injection Treatment-Related Attributes Using Time Trade-Off Among Type 2 Diabetes Patients: A Vignette-Based Study
Xinran Liu1,2, Chang Luo1,2, Shitong Xie3,4
1School of Pharmaceutical Science and Technology, Faculty of Medicine, Tianjin University, Tianjin, China.
Objectives:
To identify health utility decrements of injection treatment-related attributes among patients with type 2 diabetes mellitus (T2DM) in China.
Methods:
Health states of four attributes (hypoglycemia, dose frequency, flexibility and injection site reaction) were generated using a vignette-based method. Patients with T2DM were recruited from eight cities in China. The sample was broadly consistent with Chinese T2DM population with regard to age and sex distribution. Respondents completed seven time trade-off (TTO) tasks during face-to-face interviews. The ordinary least square (OLS), fixed effects (FE) and random effects (RE) models were used for TTO data. In subgroup analysis, groups were categorized based on whether injection treatment was currently used, number of medications, needle phobia, duration of injectable treatment and travel frequency.
Results:
A total of 400 patients (52.75% male, mean [SD] age 50.30 [12.05] years) were included in this study. Severe hypoglycemia had the largest disutility value of all attributes (-0.023, P < 0.001). Three times daily, twice daily and once daily injection (needed to be carried with the patient on short trips) were associated with -0.023 (P < 0.001), -0.018 (P < 0.001) and -0.011 (P = 0.022) disutility values compared with once weekly injection (not required to be carried with the patient on short trips), respectively. The disutility value associated with injection site reaction attribute was -0.013 (P < 0.001). In subgroup analysis, the relative importance of treatment-related attributes was found to depend on patient characteristics.
Conclusions:
This study provides disutility values associated with several injection treatment-related attributes for Chinese patients with T2DM. Hypoglycemia appears to be the most important attribute, followed by dose frequency, flexibility and injection site reaction.
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