Patients' and physicians' preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a discrete choice experiment.
Por:
Morillas, A, Feliciano, R, Fernndez Catalina, P, Ponte, C, Botella, M, Rodrigues, J, Esmatjes, E, Lafita, J, Lizan, L, Llorente, I, Morales, C, Navarro-Perez, J, Orozco D, Paz, S, Ramirez de Arellano, A, Cardoso, C and Tribaldos Causadias, M
Publicada:
14 oct 2015
Ahead of Print:
14 oct 2015
Resumen:
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: €68.14 [95% confidence interval: 54.55-85.08]) the most, followed by avoiding one hypoglycemic event/month (WTP: €54.80 [23.29-82.26]). Physicians valued avoiding one hypoglycemia/week (WTP: €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: €166.87 [88.63-843.09] and €154.30 [98.13-434.19], respectively). Physicians and patients were willing to pay €125.92 (73.30-622.75) and €24.28 (18.41-30.31), respectively, to avoid a 1% increase in glycated hemoglobin, and €143.30 (73.39-543.62) and €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.
Filiaciones:
:
Hosp Univ Dr Peset, Valencia, Spain
Feliciano, R:
USF Sao Domingos, Santarem, Portugal
Fernndez Catalina, P:
Hosp Montecelo Pontevedra, Galicia, Spain
Ponte, C:
USF Porta Sol, Matosinhos, Portugal
Botella, M:
Hosp Univ Principe Asturias, Madrid, Spain
Rodrigues, J:
USF Serra Lousa, Lousa, Portugal
Esmatjes, E:
Hosp Clin Barcelona, Barcelona, Spain
Lafita, J:
Hosp Navarra, Navarra, Spain
Lizan, L:
Univ Jaume 1, Outcomes 10, Castellon de La Plana, Spain
Llorente, I:
Hosp Univ Nuestra Senora Candelaria, Canarias, Spain
Morales, C:
Hosp Univ Virgen Macarena, Seville, Spain
Navarro-Perez, J:
Univ Valencia, CIBERESP, INCLIINCLIVA, Valencia, Spain
Orozco D:
Sociedad Espanola Med Familiar & Comunitaria, Valencia, Spain
Paz, S:
Univ Jaume 1, Outcomes 10, Castellon de La Plana, Spain
Ramirez de Arellano, A:
Novo Nordisk EU HEOR Europe, Madrid, Spain
Cardoso, C:
Novo Nordisk AS, Lisbon, Portugal
Tribaldos Causadias, M:
Univ Jaume 1, Outcomes 10, Castellon de La Plana, Spain
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