Utilities and disutilities for type 2 diabetes treatment-related attributes.
BACKGROUND
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).


CONCLUSIONS
The vignette-based approach was feasible and useful for assessing added utility or disutility of medication-related attributes.
Matza
Louis S
LS
Center for Health Outcomes Research, United BioSource Corporation, 7101 Wisconsin Ave, Suite 600, Bethesda, MD 20814, USA. louis.matza@unitedbiosource.com
Boye
Kristina S
KS
Yurgin
Nicole
N
Brewster-Jordan
Jessica
J
Mannix
Sally
S
Shorr
Jodi M
JM
Barber
Beth L
BL
D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D004739:England; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007003:Hypoglycemia / Q000523:psychology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012606:Scotland; D016896:Treatment Outcome
D007004:Hypoglycemic Agents