Patient Preferences for GLP-1 Receptor Agonist Treatment of Type 2 Diabetes Mellitus in Japan: A Discrete Choice Experiment

Abstract

Introduction The incidence and prevalence of type 2 diabetes mellitus (T2D) are increasing in Japan, and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used to treat the disease. The objective of this study was to use a discrete choice experiment (DCE) to characterize patient preferences for clinical treatment features of two GLP-1 RAs—dulaglutide 0.75 mg and semaglutide 0.50 mg—among patients with T2D in Japan. Methods Adult patients with T2D in Japan were administered the DCE via a web-based survey. The DCE examined patient preferences for five treatment attributes (each described by two or three levels), including method of administration, HbA1c change, reduction in cardiovascular (CV) risk, weight change, and common side effects (i.e., nausea). Results were analyzed using multinomial and mixed logit models, and predicted choice probability was calculated to determine the overall probability that either dulaglutide or semaglutide DCE levels were preferred. One DCE choice task included a direct comparison of the dulaglutide 0.75 mg versus semaglutide 0.50 mg treatment profiles. Results 190 subjects completed the survey; 29 were excluded after failing the predefined internal validity assessments. In the final analysis sample ( N = 161), the attribute with the largest effect on the subjects’ choices was reduction in CV risk, followed by HbA1c change and common side effects. Patients’ predicted choice probability for the semaglutide profile was 78%, versus 22% for the dulaglutide profile. 28% of patients were “very willing” to initiate treatment with semaglutide’s product profile, versus 6% for dulaglutide. Conclusion In this study, reduction in CV risk and HbA1c change were the key drivers of GLP-1 RA medication preference in Japanese patients with T2D. Overall, the majority of the patients preferred a product with attribute levels reflecting the semaglutide 0.50 mg profile, with a known CV risk reduction benefit and superior HbA1c reduction. Funding Novo Nordisk. Electronic supplementary material The online version of this article (10.1007/s13300-019-0591-9) contains supplementary material, which is available to authorized users.

Assessing patient PREFERence between the dulaglutide pen and the semaglutide pen: A crossover study (PREFER)

“…Only one published study, a discrete choice experiment (DCE), contradicts the current results by reporting no significant difference in preference between the dulaglutide and semaglutide devices . Participants in this DCE were given brief device descriptions without any further information (“single‐use, disposable prefilled pen, with no dose adjustment possible” and “multi‐dose prefilled pen, used with disposable injection needles, with dose adjustment possible”).…”

“…c Willing includes "somewhat willing" (19.7%) and "very willing" (73.9%); Not willing includes "somewhat not willing" (2.3%) and "not willing" (1.3%) Only one published study, a discrete choice experiment (DCE), contradicts the current results by reporting no significant difference in preference between the dulaglutide and semaglutide devices. 51 Participants in this DCE were given brief device descriptions without any further information ("single-use, disposable prefilled pen, with no dose adjustment possible" and "multi-dose prefilled pen, used with disposable injection needles, with dose adjustment possible"). With these minimal descriptions, respondents may not have understood the differences in procedures for preparing the injection devices and administering injections.…”

Response to “Letter to the Editor Regarding: Patient Preferences for Glucagon-like Peptide-1 (GLP-1) Receptor Agonist Treatment of Type 2 Diabetes Mellitus in Japan: A Discrete Choice Experiment”

“…We would like to thank you for the opportunity to respond to the issues raised in the letter related to our publication [1] and to provide details of the methodology to address the concerns. In the letter, the author noted concerns about the cardiovascular (CV) outcome risk reduction value used for the semaglutide 0.50 mg profile.…”

Letter to the Editor Regarding: Patient Preferences for GLP-1 Receptor Agonist Treatment of Type 2 Diabetes Mellitus in Japan: A Discrete Choice Experiment

“…Brooks et al have investigated the patient preferences for glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment among Japanese patients with type 2 diabetes mellitus (T2DM) [1]. In this study, Brooks et al used a discrete choice experiment (DCE) via web-based survey to evaluate patient preferences for clinical treatment features of two GLP-1 RAs, dulaglutide 0.75 mg and semaglutide 0.50 mg.…”

“…The CVOT-related attribute levels representing the dulaglutide 0.75 mg and semaglutide 0.50 mg treatment profile were defined as ''no data for the benefit or risk in CV diseases (heart attack, stroke, death due to CV diseases)'' and ''26% reduction of risk in CV diseases (heart attack, stroke, death due to CV diseases)'' in this study, respectively [1]. Brooks et al did not disclose the sources or references of these applied attribute levels in their publication; however, it seems that findings from Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN-6) relate to this CVOT-related attribute for semaglutide 0.5 mg since the main result of this study reports 26% reduction of risk in CV outcome events in comparison with placebo [2].…”