Quantifying Patient Preferences for Type 2 Diabetes Basal Insulin Treatments: A Discrete Choice Experiment

OBJECTIVES: Currently marketed basal insulins are administered via once daily (OD) or twice daily (BD) injections; future basal insulin treatments may be administered once weekly (OW). This study aimed to quantify the relative importance of frequency of administration in basal insulin treatment preferences of people living with type 2 diabetes (T2D).

METHODS: A discrete choice experiment (DCE) was conducted, where patients were presented with 11 choice tasks, each comprising two hypothetical basal insulin treatment profiles. Choice tasks were based on the following treatment attributes: frequency of administration, dose timing, risk of severe hypoglycemia, dose monitoring, and mode of administration. Hierarchical Bayesian estimation was used to calculate part-worth utilities or “preference weights” to estimate the relative importance (RI) of attributes.

RESULTS: N=513 patients with T2D (aged 20-90; 54% male; mean time since diagnosis: 11.6 years) completed the DCE and passed data validation checks. The multi-country sample (Canada n=155, France n=166, Spain=73 and Japan=119) comprised patients who were basal insulin experienced (n=161), insulin naïve but injection experienced (n=176), or insulin and injection naïve (n=176). Frequency of administration was the most important attribute (RI = 40%) across all patient categories, with raw outputs indicating a preference towards OW administration over OD, with BD least preferred. This was followed by risk of severe hypoglycemia for insulin experienced patients (RI = 20%), dose monitoring (RI = 13%), timing of dose (RI = 10%), mode of administration (RI = 9%) and risk of severe hypoglycemia for insulin naïve patients (RI = 8%). Preferences were consistent across countries and treatment experiences, with frequency of administration consistently ranked as most important.

CONCLUSIONS: Frequency of administration emerged as a key preference driver for basal insulin treatment among people living with T2D, with a preference towards OW administration. This highlights the potential for future OW insulins to offer more patient-centric treatment options.