Author(s)
Kelley M1, Wadwa P2, Buckingham B3, Thankamony A4, Campbell F5, Weinzimer S6, Mauras N7, DiMeglio L8, Denvir L9, Davis N10, Ghatak A11, Besser R12, Fox DS1
1University of Southern California, Los Angeles, CA, USA, 2University of Colorado, Aurora, CO, USA, 3Stanford University, Palo Alto, CA, USA, 4University of Cambridge, Cambridge, Cambridge, UK, 5St. James University Hospital, Leeds, West Yorkshire, UK, 6Yale University, New Haven, CT, USA, 7Nemours Children’s Clinic, Jacksonville, FL, USA, 8Indiana University, Indianapolis, IN, USA, 9Nottingham Children’s Hospital, Nottingham, Nottinghamshire, UK, 10Southampton Children’s Hospital, Southampton, Hampshire, UK, 11Alder Hey Children’s Hospital, Liverpool, North West England, UK, 12Oxford University Hospitals NHS Foundation Trust, Oxford, Oxford, UK
OBJECTIVES: Patient willingness to trade-off the benefits and disadvantages of closed loop insulin pump systems has not previously been reported. Understanding patient preferences is critical to increasing acceptability and uptake. This study quantified the relative importance of various features for hypothetical closed-loop insulin systems via discrete choice experiment (DCE). METHODS: The DCE was administered repeatedly during a randomized controlled trial to assess how device preferences might change after experiencing a closed-loop system. The DCE included 4 attributes, each with 3-4 levels: daily time required, overall disease control, improvement in daily life, and monthly out-of-pocket costs. Each participant completed 12 choice tasks, implemented using Sawtooth’s web-based Discover platform. Analysis applied panel data mixed-logit models to responses over time, controlling for treatment status and geography. Separate mixed logits, stratified by treatment group and location, also quantified subgroup preference heterogeneity. RESULTS: 123 respondents completed all choice tasks and surveys. Improved disease control showed greatest relative importance in the main model. Increasing disease control from reasonable to excellent yielded approximately 1.4, 1.6, and 2.3 as much utility as: decreasing out-of-pocket costs from $200 to $25, changing daily life from normal to moderately impacted, or decreasing daily time required from 60 to 5 minutes, respectively. Subgroup analysis comparing US and UK responses stratified by time, revealed that from baseline to 6 months the relative importances of daily life and disease control decreased, while the relative importance of out-of-pocket cost increased – all only for US respondents. For UK respondents, relative importance remained similar over time. Further analysis comparing treatment and control groups stratified by time, but treating all attributes as fixed, revealed that the relative importance of management time decreased somewhat in the treatment group, but nearly doubled in the control group. CONCLUSIONS: Participants demonstrated very strong tradeoff preferences for closed-loop insulin systems with the greatest overall disease control.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Acceptance Code
PR3
Topic
Medical Technologies, Patient-Centered Research
Topic Subcategory
Medical Devices, Stated Preference & Patient Satisfaction
Disease
Diabetes/Endocrine/Metabolic Disorders, Medical Devices, Pediatrics
