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RESEARCH PRODUCT
Patients' and physicians' preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a discrete choice experiment.
Carlos MorillasRosa FelicianoPablo Fernández CatalinaCarla PonteMarta BotellaJoão RodriguesEnric EsmatjesJavier LafitaLuis LizánIgnacio LlorenteCristóbal MoralesJorge Navarro-pérezDomingo Orozco-beltranSilvia PazAntonio Ramirez De ArellanoCristina CardosoMaribel Tribaldos Causadiassubject
:Geographicals::Geographic Locations::Europe::Portugal [Medical Subject Headings]cardiovascular riskHbA1cendocrine system diseases:Analytical Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Mass Index [Medical Subject Headings]:Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Hypoglycemia [Medical Subject Headings]:Disciplines and Occupations::Health Occupations::Medicine::Public Health [Medical Subject Headings]:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings]:Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]:Named Groups::Persons::Occupational Groups::Health Personnel::Physicians [Medical Subject Headings]HbA(1c)HbA:Diseases::Pathological Conditions Signs and Symptoms::Signs and Symptoms::Body Weight::Body Weight Changes::Weight Loss [Medical Subject Headings]:Diseases::Cardiovascular Diseases [Medical Subject Headings]preferences:Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings]diabetesnutritional and metabolic diseasesPeso corporalweightPérdida de peso:Health Care::Health Care Facilities Manpower and Services::Health Facilities::Ambulatory Care Facilities [Medical Subject Headings]Diabetes mellitus tipo 2:Diseases::Pathological Conditions Signs and Symptoms::Signs and Symptoms::Signs and Symptoms Digestive::Nausea [Medical Subject Headings]hypoglycemia:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models Statistical::Logistic Models [Medical Subject Headings]:Diseases::Pathological Conditions Signs and Symptoms::Signs and Symptoms::Body Weight [Medical Subject Headings]:Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus::Diabetes Mellitus Type 2 [Medical Subject Headings]:Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Hypoglycemic Agents [Medical Subject Headings]Enfermedades cardiovascularesHipoglucemiawillingness to pay:Check Tags [Medical Subject Headings]discrete choice modeldescription
Objective: 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. Methods: 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. Results: 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: (sic)68.14 [95% confidence interval: 54.55-85.08]) the most, followed by avoiding one hypoglycemic event/month (WTP: (sic)54.80 [23.29-82.26]). Physicians valued avoiding one hypoglycemia/week (WTP: (sic)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: (sic)166.87 [88.63-843.09] and (sic)154.30 [98.13-434.19], respectively). Physicians and patients were willing to pay (sic)125.92 (73.30-622.75) and (sic)24.28 (18.41-30.31), respectively, to avoid a 1% increase in glycated hemoglobin, and (sic)143.30 (73.39-543.62) and (sic)42.74 (23.89-61.77) to avoid nausea. Conclusion: 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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-01-01 |