OBJECTIVES : Limited data exist evaluating patients’ WTP for insulin analogue treatment in countries with mainly out-of-pocket payment markets, such as India. This study investigated WTP for BIAsp 30 in patients with T2D in India.

METHODS : A multicenter, prospective, non-interventional study (data collection: 2017/18) in patients previously treated with biphasic human insulin (BHI) in vials and believed able to pay for BIAsp 30 in a FlexPen^® or using a Penfill^®. The primary endpoint was the proportion of patients willing to pay for BIAsp 30 after 12 weeks. Secondary endpoints were change from baseline in treatment and device satisfaction, and patient preferences for treatment attributes revealed through a nested discrete choice experiment (DCE) at baseline (defined as a clinical decision to initiate BIAsp 30). DCE results were analyzed by mixed logit models.

RESULTS : 54.9% of participants were male (n=277/505); mean participant age was 56.4 years and mean diabetes duration 10.9 years. 63.8% of participants had BMI ≥25 kg/m² and 48.5% had an annual household income 150,000–340,000 Indian Rupees (INR). After 12 weeks’ treatment, 96.4% of participants were willing and able to pay for BIAsp 30. Mean treatment and device satisfaction significantly improved from baseline (p<0.001). The following mean [95% CI] WTP results are reported in INR. Participants were willing to pay 3576 [2755; 4398] for improved glycemic control, 688 [383; 994] for a device upgrade (syringe to Penfill^®), or 327 [95; 560] to avoid major hypoglycemia. Additionally, participants would need to be compensated 44 [56; 32] per minor hypoglycemic event.

CONCLUSIONS : After 12 weeks, Indian patients with T2D previously treated with BHI were willing to pay for BIAsp 30 in a FlexPen^® or Penfill^®. Furthermore, switching to BIAsp 30 in a FlexPen^® or Penfill^® improved treatment and device satisfaction. This study increases prescribers’ understanding of WTP for BIAsp 30 in India.