Pharmacologic Treatment of Type 2 Diabetes

Tran, Linda; Zielinski, Angela; Roach, Arpi H.; Jende, Jennifer A.; Householder, Ann Marie; Cole, Emily E.; Atway, Shuruq A.; Amornyard, Melinda; Accursi, Mallory L.; Shieh, Suzanna W.; Thompson, Erin E.

doi:10.1177/1060028015573010

Cited by 24 publications

(14 citation statements)

References 152 publications

(317 reference statements)

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“…Several GLP-1 receptor agonists are now available as weekly injections [ 28 – 30 ]. These treatments have some important strengths and weaknesses in common, including effectiveness for lowering HbA1c, fasting blood glucose, and body weight [ 25 , 31 , 32 ]; low risk of hypoglycemia [ 32 ]; and gastrointestinal adverse events [ 26 , 31 , 32 ]. Despite these commonalities, these weekly treatments and their injection devices differ in terms of treatment process attributes, such as needle handling and steps required to prepare the medication.…”

Section: Introductionmentioning

confidence: 99%

Health state utilities associated with attributes of weekly injection devices for treatment of type 2 diabetes

Matza¹,

Boye

Stewart³

et al. 2017

BMC Health Serv Res

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BackgroundGlucagon-like peptide-1 (GLP-1) receptor agonists are often recommended as part of combination therapy for type 2 diabetes when oral medication does not result in sufficient glycemic control. Several GLP-1 receptor agonists are available as weekly injections. These medications vary in their injection delivery systems, and these differences could impact quality of life and treatment preference. The purpose of this study was to estimate utilities associated with attributes of injection delivery systems for weekly GLP-1 therapies.MethodsParticipants with type 2 diabetes in the UK valued health states in time trade-off interviews. The health states (drafted based on literature, device instructions for use, and clinician interviews) had identical descriptions of type 2 diabetes, but differed in description of the treatment process. One health state described oral treatment, while six others described oral treatment plus a weekly injection. The injection health states varied in three aspects of the treatment administration process: requirements for reconstituting the medication (i.e., mixing the medication prior to the injection), waiting during medication preparation, and needle handling. Every participant valued all seven health states.ResultsA total of 209 participants completed interviews (57.4% male; mean age = 60.4y). The mean utility of the oral treatment health state was 0.89. All injection health states had significantly (p < 0.01) lower utilities ranging from 0.86 to 0.88. Differences among health state utilities suggest that each administration requirement had a small but measureable disutility: -0.004 (reconstitution), -0.004 (needle handling), -0.010 (reconstitution, needle handling), and -0.020 (reconstitution, waiting, needle handling).ConclusionsFindings suggest it is feasible to use the TTO method to quantify preferences among injection treatment processes. It may be useful to incorporate these utility differences into cost-utility models comparing weekly injectable treatments for patients with type 2 diabetes.

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Section: Introductionmentioning

confidence: 99%

Health state utilities associated with attributes of weekly injection devices for treatment of type 2 diabetes

Matza¹,

Boye

Stewart³

et al. 2017

BMC Health Serv Res

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“…Long‐term cost‐effectiveness was evaluated using the IQVIA CORE Diabetes Model (IQVIA, Basel, Switzerland). Specifications and features of this model have been previously described and model validation analyses comparing model projections with real‐life datasets have been published . The model is a validated, non‐product‐specific diabetes policy analysis tool, capable of performing real‐time simulations, taking into account patient characteristics, risk factors and medical history, as well as the effects of screening and multi‐factorial treatment strategies for complications.…”

Section: Methodsmentioning

confidence: 99%

“…Specifications and features of this model have been previously described and model validation analyses comparing model projections with real-life datasets have been published. 11,12 The model is a validated, non-product-specific In line with published guidance, a long-term time horizon (50 years) was chosen to capture the relevant complications and associated costs frequently observed in type 2 diabetes, in order to assess their impact on life expectancy and quality-adjusted life expectancy (all patients had died by the end of the simulation). 13 Future costs and clinical benefits were discounted at 3.5% annually, as recommended for health economic analyses for the UK.…”

Section: Modelmentioning

confidence: 99%

Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A long‐term cost‐effectiveness analysis

Barnett

Arnoldini²,

Hunt³

et al. 2018

Diabetes Obesity Metabolism

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“…GLP-1 RAs can be effective in lowering blood glucose levels and body weight, with a low risk of hypoglycemia [ 11 , 18 – 20 ]. The most commonly reported adverse events are gastrointestinal side effects [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

Development of the Diabetes Injection Device Experience Questionnaire (DID-EQ) and Diabetes Injection Device Preference Questionnaire (DID-PQ)

Matza

Boye

Stewart

et al. 2018

J Patient Rep Outcomes

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BackgroundPrevious research has examined patient perceptions of insulin injection devices. However, injectable medications other than insulin are increasingly used to treat type 2 diabetes, including GLP-1 receptor agonists. No patient-reported outcome (PRO) instruments have been developed taking into account the experiences of patients using newer injection devices, which are often different from devices used for insulin. Therefore, the purpose of this qualitative study was to develop two draft PRO instruments focusing on patients’ experiences with these newer injection devices (one instrument assessing perceptions of a single injection device, and another assessing preferences between two devices).MethodsQuestionnaire development proceeded in six steps: literature review, interviews with six device experts, concept elicitation interviews with patients (N = 32), preliminary translatability assessment, cognitive interviews with patients (N = 20), and final translatability assessment.ResultsLiterature review and expert interviews were conducted to inform a concept elicitation interview guide. In concept elicitation in the US, UK, and Germany, patients with type 2 diabetes reported a range of injection features that influenced their perceptions of non-insulin injection devices (e.g., requirements for preparation of the medication/device, issues related to the needle, ease-of-use, portability). Two draft “item pools” were developed based on the literature review, expert interviews, and concept elicitation results. In cognitive interviews, patients recommended minor revisions and indicated that the draft instruments were generally clear, comprehensible, and relevant to their experience with non-insulin injectable medication. The instruments were refined based on the cognitive interviews and translatability assessment, resulting in two questionnaires.ConclusionsThe various steps of qualitative research support the content validity of these new PRO instruments, which are the first developed specifically to assess perceptions of non-insulin injection delivery systems. Despite some overlap with insulin-focused questionnaires, the new instruments are distinct from previous instruments (omitting content that would not be relevant to patients receiving non-insulin injectable treatment, while including content that is not included in the insulin focused instruments). This qualitative research yielded two draft questionnaires that are grounded in patient perceptions and ready for psychometric validation studies with larger samples of patients with type 2 diabetes.

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Pharmacologic Treatment of Type 2 Diabetes

Cited by 24 publications

References 152 publications

Health state utilities associated with attributes of weekly injection devices for treatment of type 2 diabetes

Health state utilities associated with attributes of weekly injection devices for treatment of type 2 diabetes

Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A long‐term cost‐effectiveness analysis

Development of the Diabetes Injection Device Experience Questionnaire (DID-EQ) and Diabetes Injection Device Preference Questionnaire (DID-PQ)

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