OBJECTIVES: Several GLP-1 receptor agonists are administered as weekly injections for treatment of type 2 diabetes (T2D). These medications vary in their injection processes, and these differences could impact quality of life and patient preference. The purpose of this study was to examine patient preferences in Italy and estimate utilities associated with injection processes for these weekly therapies.

METHODS: Participants diagnosed with T2D in Italy (Milan, Rome) valued health states in time trade-off interviews. The health states (drafted based on literature, device instructions for use, and clinician interviews) had identical descriptions of T2D, but differed in description of the treatment process. One health state described an oral only treatment regimen, while six health states described oral treatment plus a weekly injection. The injection health states differed in the treatment administration process (e.g., requirements for reconstituting the medication, waiting during medication preparation, and needle handling).

RESULTS: A total of 238 participants completed interviews (58.8% male; mean age = 60.2y; 118 from Milan; 120 from Rome). The mean (SD) utility of the oral treatment health state was 0.90 (0.10), and all injection health states had significantly (all p < 0.0001) lower utilities ranging from 0.87 (reconstitution, waiting, and handling) to 0.89 (weekly injection without any of the three treatment administration requirements). Utility differences among the injection health states suggest that each administration requirement had a small but measureable disutility (i.e., negative utility difference). Disutility values include -0.006 (reconstitution), -0.006 (needle handling), -0.011 (reconstitution, needle handling), and -0.022 (reconstitution, waiting, needle handling).

CONCLUSIONS: Findings provide insight into patient preferences among attributes of weekly T2D injection treatment processes in this Italian sample. Results suggest that injection device attributes may be important to some patients, and it may be useful for clinicians to consider these attributes when choosing medication for patients initiating these weekly treatments.