Preferences for basal insulin treatments in adults with type 2 diabetes: A discrete choice experiment in France and Spain.

Overview

abstract

AIM: To quantify the relative importance of frequency of administration in basal insulin treatment preferences of people living with type 2 diabetes (T2D) in France and Spain, using a discrete choice experiment (DCE). MATERIALS AND METHODS: A targeted literature review and qualitative patient interviews informed an attributes and levels grid consisting of six attributes (2-3 levels each). Pilot interviews were conducted to test the DCE. A quantitative DCE survey was administered to adults with T2D in France and Spain. Hierarchical Bayesian estimation was used to identify the relative importance of each attribute. RESULTS: The survey was completed by N = 239 participants from France (n = 166) and Spain (n = 73) across three treatment experience categories: basal insulin and injectable glucagon-like peptide-1 receptor agonists (GLP-1 RA) naïve (n = 86), basal insulin naïve but injectable GLP-1 RA experienced (n = 85), and basal insulin experienced (n = 68). Frequency of administration had a relative importance of 39%, nearly double that of the attribute with the next highest relative importance 'risk of severe hypoglycemic event (insulin experienced rates)' (21%). A preference for once weekly (OW) administration was observed relative to once daily (OD) or twice daily (BD). Reduction in the frequency of missing doses and taking doses at the prescribed time were considered the most positive impacts of OW administration. Findings were consistent across treatment experience groups. CONCLUSION: This study highlights the importance of administration frequency in basal insulin treatment decisions when glycemic control is held constant. Participants indicated a preference for OW injection frequency, suggesting fewer injections may reduce the burden of insulin administration. These insights support clinical consideration of less frequent injections when making T2D treatment decisions.