The Burden of Type 2 Diabetes and the Value of Achieving Near Normoglycemia from the Patient Perspective

Gelhorn, Heather L.; Balantac, Zaneta; Shinde, Shraddha; Thieu, Vivian T.; Boye, Kristina S.

doi:10.1007/s13300-021-01054-6

Cited by 9 publications

(8 citation statements)

References 31 publications

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“…Utility elicitation interviews were carried out with members of the general public in each of three countries (representing Europe, North America, and Asia), as preferred by relevant HTA bodies [ 11 – 13 ]. This sample size of ≥ 100 participants is also broadly consistent with prior research in T2DM on utility elicitation [ 16 – 18 , 32 – 34 ], or patient preferences in general [ 35 , 36 ]. In addition, a moderated 1:1 interview method (with highly consistent electronic data collection) was used, which represents the gold standard for health state valuation [ 23 ].…”

Section: Discussionsupporting

confidence: 77%

Disutility of injectable therapies in obesity and type 2 diabetes mellitus: general population preferences in the UK, Canada, and China

et al. 2022

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Introduction Once-daily and once-weekly injectable glucagon-like peptide-1 receptor agonist therapies (GLP-1 RAs) are established in obesity and type 2 diabetes mellitus (T2DM). In T2DM, both once-daily and once-weekly insulin are expected to be available. This study elicited utilities associated with these treatment regimens from members of the general public in the UK, Canada, and China, to quantify administration-related disutility of more-frequent injectable treatment, and allow economic modelling. Methods Two anchor states (no pharmacological treatment), and seven treatment states (daily oral tablet and generic injectable regimens of variable frequency), with identical outcomes were tested A broadly representative sample of the general public in each country participated (excluding individuals with diabetes or pharmacologically treated obesity). An adapted Measurement and Valuation of Health protocol was administered 1:1 in web-enabled interviews by trained moderators: visual analogue scale (VAS) as a “warm-up”, and time trade-off (TTO) using a 20-year time horizon for utility elicitation. Results A total of 310 individuals participated. The average disutility of once-daily versus once-weekly GLP-1 RA was − 0.048 in obesity and − 0.033 in T2DM; the corresponding average disutility for insulin was − 0.064. Disutilities were substantially greater in China, relative to UK and Canada. Discussion Within obesity and T2DM, more-frequent treatment health states had lower utility. Scores by VAS also followed a logical order. The generated utility values are suitable for use in modelling injectable therapy regimens in obesity and T2DM, due to the use of generic descriptions and assumption of equal efficacy. Future research could examine the reasons for greater administration-related disutility in China.

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Section: Discussionsupporting

confidence: 77%

Disutility of injectable therapies in obesity and type 2 diabetes mellitus: general population preferences in the UK, Canada, and China

et al. 2022

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“…Prior research has demonstrated that improvements in HbA1c, and specifically reaching near normoglycemia, is both meaningful and important to people with T2D in the US and UK. 18,19 This study demonstrates that the properties of tirzepatide, a novel, weekly, GIP/GLP-1 RA for T2D are valuable to people with T2D living in the US and UK. The tirzepatide efficacy and safety profiles differ from those of other T2D treatments that are currently available.…”

mentioning

confidence: 79%

“…This result is not surprising given past research has demonstrated people with T2D in the US and UK place a great deal of importance on reaching near normoglycemia and associate this with a range of positive impacts. 18 , 19 Weight reduction also influenced preferences; however, this attribute was secondary to HbA1c reduction in both countries (US RAI: 18.3%; UK RAI: 17.3%). The RAI for delivery system was higher in the US (RAI: 20.9%) than in the UK (RAI: 9.2%), with patients in both countries preferring the single-use, pre-filled pen over the multi-use, dial-a-dose pen.…”

Section: Discussionmentioning

confidence: 99%

“…17 Prior research has demonstrated that achieving near normoglycemia (defined as HbA1c levels near 5.7%) is considered by the majority of people with T2D to be a paradigm shift and viewed as both meaningful and important. 18,19 Thus, the new GIP/GLP-1 RA could provide meaningful benefits for people with T2D, given both the potential for significant reductions in HbA1c and weight loss, and also the association between T2D, obesity and negative health outcomes. However, it is unknown how people with T2D value the substantial reductions in HbA1c and weight loss.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Substantial Improvements in HbA1c and Weight Loss on the Medication Preferences of People with Type 2 Diabetes

Gelhorn¹,

Osumili²,

Brown³

et al. 2023

PPA

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Purpose To quantify the preferences of people with type 2 diabetes (T2D) for treatment attributes of a glucose-dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist (RA) versus an injectable GLP-1 RA medication profile. Patients and Methods Injection-naive people taking oral medications for T2D in the US and UK completed a web survey including a discrete choice experiment to quantify patients’ preferences for five treatment attributes: delivery system, frequency of nausea, frequency of hypoglycemia, HbA1c reduction, and weight reduction. Attributes and levels were based on head-to-head clinical trial data of tirzepatide 5mg, 10mg, and 15mg versus semaglutide 1mg. Preference data were analyzed separately by country using multinomial mixed logit (MXL) models. MXL parameters were used to estimate the predicted preference for each tirzepatide dose versus semaglutide 1mg. Direct preferences for each dose of tirzepatide versus semaglutide 1mg were elicited. Results Participants (N=620) in the US (N=301) and UK (N=319) were 50.8% and 50.5% female with mean ages of 60.7 years and 58.9 years, respectively. The order and magnitude of relative attribute importance (RAI) scores differed between countries. HbA1c reduction (26.3%) had the greatest impact on US participants’ preferences, and hypoglycemia (32.8%) did among UK participants. Attribute-level marginal utility results indicated preferences for greater HbA1c improvements, the single-use pre-filled pen, lower hypoglycemia, greater weight reductions, and lower frequency of nausea. Assuming the availability of only tirzepatide or semaglutide 1mg, the predicted preference for tirzepatide (5, 10, and 15mg) in the US is 95.6% (vs 4.4% for semaglutide 1mg) and in the UK was 86.3% (vs 13.7% for semaglutide 1mg). Conclusion HbA1c reduction, frequency of hypoglycemia, and weight reduction are key drivers of preferences among people with T2D when considering medication options. Overall, people with T2D are likely to prefer the tirzepatide over the semaglutide 1mg medication profiles.

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“…2,3 Despite the breadth of available treatments, people with T2D struggle with glycemic management, with nearly half of those with T2D having an HbA1c value of 7.0% or higher, in addition to having a variety of unmet needs while experiencing a wide range of impacts. [4][5][6] Previous research has found that poor glycemic management among people with T2D is associated with feelings of self-blame, poor psychological well-being, and diabetes-related worries. 7,8 A recent qualitative concept elicitation study was conducted to understand and document what achieving near normoglycemia (HbA1c levels near 5.7% or those observed among individuals without T2D) would mean to people with T2D.…”

Section: Introductionmentioning

confidence: 99%

The Benefits of Safely Achieving Near Normoglycemia from the Perspective of People with Type 2 Diabetes: A Quantitative Survey Study

Gelhorn¹,

Ross²,

Shinde³

et al. 2022

PPA

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Purpose To understand the perspectives of people with type 2 diabetes (T2D) on safely reaching near normoglycemia, defined as a glycated hemoglobin A1c (HbA1c) value of <6%. HbA1c indicates the average blood sugar level over the past few months. Patients and Methods This cross-sectional online quantitative survey of people with T2D asked about the current impacts of T2D, the anticipated benefits of safely achieving near normoglycemia among participants with a current HbA1c ≥6%, or the actual benefits of safely achieving near normoglycemia among participants who had an HbA1c <6%. Participants reported on specific areas of psychological/emotional impact of T2D and the psychological/emotional benefits of achieving near normoglycemia. Results Participants (N = 1000; United States = 500 and United Kingdom = 500) were 53.1% male and had a mean age of 62.9 years (SD = 13.3). The majority reported that the current HbA1c ≥6% (81.2%) and 49.2% had been diagnosed more than 10 years ago. The vast majority of participants (>90%) indicated that achieving near normoglycemia was meaningful, with 95% of the participants indicating that achieving near normoglycemia would be of somewhat or extreme importance to them. In total, 93.8% of participants with a current HbA1c ≥6% and 80.3% of those with a current HbA1c <6% anticipated/reported having experienced improvements as a result of achieving near normoglycemia. Among those who experienced or anticipated positive psychological/emotional impacts (n = 247), the most commonly reported impacts included less worry about future diabetes-related complications (79.8%), feeling in control over one’s life (72.9%), and overall health-related quality of life (59.9%). Conclusion Achieving near normoglycemia is both meaningful and important to the majority of people with T2D, including both those who have and those who have not experienced reaching near normoglycemia. A wide range of specific impacts, including psychological/emotional concepts, are experienced by people with T2D, many of which may be improved through achieving near normoglycemia.

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The Burden of Type 2 Diabetes and the Value of Achieving Near Normoglycemia from the Patient Perspective

Cited by 9 publications

References 31 publications

Disutility of injectable therapies in obesity and type 2 diabetes mellitus: general population preferences in the UK, Canada, and China

Disutility of injectable therapies in obesity and type 2 diabetes mellitus: general population preferences in the UK, Canada, and China

The Impact of Substantial Improvements in HbA1c and Weight Loss on the Medication Preferences of People with Type 2 Diabetes

The Benefits of Safely Achieving Near Normoglycemia from the Perspective of People with Type 2 Diabetes: A Quantitative Survey Study

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