title: Utility values for symptomatic non-severe hypoglycaemia elicited from persons with and without diabetes in Canada and the United Kingdom.
abstract: OBJECTIVE
  To elicit societal and patient utilities associated with diabetic symptomatic non-severe hypoglycaemia for three health states: 1) rare (quarterly), 2) intermittent (monthly), 3) and frequent (weekly) hypoglycaemia episodes.
  
  
  METHODS
  Using validated health states, time trade-off utilities were elicited from 51 Canadian respondents with diabetes, and 79 respondents in Canada and 75 respondents in the United Kingdom (UK) without diabetes.
  
  
  CONCLUSIONS
  Each hypoglycaemic episode was associated with a reduction in utility and persons with diabetes consistently reported slightly higher utility values than respondents without diabetes. The utility for diabetes without hypoglycaemia ranged from 0.88 to 0.97, the mean utility for rare hypoglycaemic events (quarterly) ranged between 0.85 and 0.94. The utility for the intermittent state (monthly) ranged from 0.77 to 0.90 and from 0.66 to 0.0.83 for the frequent state (weekly). Differences were observed between respondents without diabetes in Canada and the UK. Using a multivariate linear OLS regression, the estimated utilities associated with a single hypoglycaemic event were -0.0033 and -0.0032 for respondents with diabetes and without diabetes, respectively.
  
  
  CONCLUSIONS
  Among respondents with and without diabetes, there was a demonstrable utility loss associated with hypoglycaemia. Considering a utility loss of 0.03 as a minimum clinically important difference for persons with diabetes, the evidence from this study indicates that as low as ten symptomatic non-severe hypoglycaemic episodes per year may be of clinical importance and that the importance increases with frequency of episodes. Integrating directly elicited utility values such as those reported here will improve the quality and applicability of economic evaluations of diabetes treatment.
authors.affiliation: Oxford Outcomes Ltd,, Vancouver, BC, Canada. adrian.levy@oxfordoutcomes.com
authors.forename: Adrian R
authors.initials: AR
authors.lastname: Levy
authors.forename: Torsten Lu
authors.initials: TL
authors.lastname: Christensen
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D017050:Episode of Care; D005260:Female; D006304:Health Status; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000523:psychology*; D007328:Insulin / Q000627:therapeutic use*; D007331:Insulin Coma; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D018434:Sickness Impact Profile; D006113:United Kingdom; D026712:Value of Life; D055815:Young Adult
chemical_list: D007328:Insulin