Is There Any difference in Preferences Between Patients and Physicians? Evidence From Anti-Hyperglycemic Medications Choices for Type 2 Diabetes
Author(s)
Yuliang Xiang, PhD, liu liu, PhD, Shimeng Liu, PhD, Yingyao Chen, PhD;
Fudan University, School of Public Health, Shanghai, China
Fudan University, School of Public Health, Shanghai, China
Presentation Documents
OBJECTIVES: This study aimed to investigate differences in preferences between Chinese patients with type 2 diabetes (T2DM) and physicians when choosing anti-hyperglycemic medicine.
METHODS: The study collected preference data through a discrete choice experiment (DCE). Patient data were collected via face-to-face surveys at 28 healthcare institutions, selected from two cities each in the eastern, central, and western regions of China. Physician data were collected through online questionnaires, covering a total of seven provinces. Seven medication attributes—treatment efficacy (HbA1c reduction), risk of hypoglycemia, gastrointestinal side effects, weight change, cardiovascular benefits, mode of administration, and out-of-pocket cost—were developed through literature review, expert consultation, and best-worst scaling with T2DM patients. Data were analyzed using Conditional-Logit and Mixed-Logit models to calculate marginal willingness to pay (mWTP). The preference heterogeneity was explored using a latent class model (LCM).
RESULTS: A total of 1,793 valid patient questionnaires and 168 valid physician questionnaires were collected. The results showed that out-of-pocket cost, treatment efficacy (β=1.18, p=0.00), and risk of hypoglycemia (β=1.11, p=0.00) were the primary concerns for patients, while physicians prioritized the risk of hypoglycemia (β=0.98, p=0.00), cardiovascular benefits (β=0.93, p=0.00), and out-of-pocket cost. Regarding mWTP, patients showed the highest willingness to pay for medications offering a 2.5% HbA1c reduction (mWTP=¥295), while physicians preferred medications with a 1.5% HbA1c reduction (mWTP=¥372). Additionally, physicians exhibited a willingness to pay (mWTP=¥864) for medications providing cardiovascular protection, 3.1 times higher than patients’ (mWTP=¥277). A strong preference for out-of-pocket cost was observed in a patient subclass, whereas physicians exhibited a lower preference.
CONCLUSIONS: The study indicates significant differences in medication preferences between patients and physicians, particularly regarding efficacy, administration mode, weight change, and cardiovascular benefit. Out-of-pocket cost and gastrointestinal side effects are common concerns for both groups. Clinical decision-making should consider patients’ medication preferences to enhance shared decision-making and patient-centered care.
METHODS: The study collected preference data through a discrete choice experiment (DCE). Patient data were collected via face-to-face surveys at 28 healthcare institutions, selected from two cities each in the eastern, central, and western regions of China. Physician data were collected through online questionnaires, covering a total of seven provinces. Seven medication attributes—treatment efficacy (HbA1c reduction), risk of hypoglycemia, gastrointestinal side effects, weight change, cardiovascular benefits, mode of administration, and out-of-pocket cost—were developed through literature review, expert consultation, and best-worst scaling with T2DM patients. Data were analyzed using Conditional-Logit and Mixed-Logit models to calculate marginal willingness to pay (mWTP). The preference heterogeneity was explored using a latent class model (LCM).
RESULTS: A total of 1,793 valid patient questionnaires and 168 valid physician questionnaires were collected. The results showed that out-of-pocket cost, treatment efficacy (β=1.18, p=0.00), and risk of hypoglycemia (β=1.11, p=0.00) were the primary concerns for patients, while physicians prioritized the risk of hypoglycemia (β=0.98, p=0.00), cardiovascular benefits (β=0.93, p=0.00), and out-of-pocket cost. Regarding mWTP, patients showed the highest willingness to pay for medications offering a 2.5% HbA1c reduction (mWTP=¥295), while physicians preferred medications with a 1.5% HbA1c reduction (mWTP=¥372). Additionally, physicians exhibited a willingness to pay (mWTP=¥864) for medications providing cardiovascular protection, 3.1 times higher than patients’ (mWTP=¥277). A strong preference for out-of-pocket cost was observed in a patient subclass, whereas physicians exhibited a lower preference.
CONCLUSIONS: The study indicates significant differences in medication preferences between patients and physicians, particularly regarding efficacy, administration mode, weight change, and cardiovascular benefit. Out-of-pocket cost and gastrointestinal side effects are common concerns for both groups. Clinical decision-making should consider patients’ medication preferences to enhance shared decision-making and patient-centered care.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
P45
Topic
Patient-Centered Research
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)