Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study.
BACKGROUND
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) differ in efficacy, side effects, dosing frequency, and device-related attributes. This study assessed the relative importance of treatment-related attributes in influencing preferences for GLP-1RAs among injection-naïve patients with type 2 diabetes mellitus (T2DM).


METHODS
Injection-naïve T2DM patients from five countries completed a Web-based discrete choice experiment (DCE) survey. Patients chose between hypothetical treatment profiles reflecting important and differentiating attributes of GLP-1RAs. Eight attributes were included: efficacy, side effects, device size, needle size, titration, preparation, evidence of long-term efficacy/safety, and dosing frequency. Odds ratios (ORs) and 95% confidence intervals were calculated using a conditional logit model to indicate the likelihood of choosing a treatment with a given attribute level versus a reference attribute level. The influence of individual attributes when considering full treatment profiles was examined using exenatide once weekly (QW) and liraglutide once daily (QD) as case examples.


RESULTS
A total of 1482 patients with T2DM completed the DCE survey. Side effects, efficacy, and dosing frequency were the three most important attributes influencing preferences; needle size, device size, and required preparation were least important. Total sample analysis indicated that a profile of GLP-1RA approximating exenatide QW (single pen) was preferred over a profile approximating liraglutide QD (OR 3.36; p < 0.001), when efficacy was assumed to be equal.


CONCLUSIONS
The most influential drivers of treatment preferences for a hypothetical GLP-RA profile were side effects, efficacy, and dosing frequency among injection-naïve T2DM patients. Preference elicitation can promote patient-centered care and inform new generations of T2DM treatments, which can lead to improved adherence and health outcomes.
AstraZeneca, Gaithersburg, MD, USA. lei.qin@astrazeneca.com.
Lei
L
Qin
AstraZeneca, Gaithersburg, MD, USA.
Stephanie
S
Chen
ICON plc, Clinical Outcomes Assessments, Gaithersburg, MD, USA.
Emuella
E
Flood
AstraZeneca, Gaithersburg, MD, USA.
Alka
A
Shaunik
ICON plc, Clinical Outcomes Assessments, Gaithersburg, MD, USA.
Beverly
B
Romero
ICON plc, Clinical Outcomes Assessments, Gaithersburg, MD, USA.
Marie
M
de la Cruz
ICON plc, Medical Affairs Statistical Analysis, San Diego, CA, USA.
Cynthia
C
Alvarez
AstraZeneca, Gaithersburg, MD, USA.
Susan
S
Grandy
Conjoint; Device; Dosing frequency; Exenatide; Liraglutide; Type 2 diabetes mellitus