Be Careful What You Ask For- Effects of Benefit Descriptions on Diabetes Patients’ Benefit-Risk Tradeoff Preferences

Apr 1, 2017, 00:00 AM
Section Title : Preference-Based Assessments
Section Order : 18
First Page : 670


As more studies report on patient preferences for diabetes treatment, identifying diabetes outcomes other than glycated hemoglobin (HbA ) to describe effectiveness is warranted to understand patient-relevant, benefit-risk tradeoffs.


The aim of the study was to evaluate how preferences differ when effectiveness (glycemic control) is presented as long-term sequela (LTS) risk mitigation rather than an asymptomatic technical marker (HbA ).


People with type 2 diabetes and using insulin (n = 3160) were randomly assigned to four self-administered, discrete-choice experiments that differed by their presentation of effectiveness. Epidemiologic reviews were conducted to ensure a close approximation of LTS risk relative to HbA levels. The relative importance of treatment benefit-risk characteristics and maximum acceptable risk tradeoffs was estimated using an error-component logit model. Log-likelihood ratio tests were used to compare parameter vectors.


In total, 1031 people responded to the survey. Significantly more severe hypoglycemic events were accepted for a health improvement in terms of LTS mitigation versus HbA improvement (0.7 events per year; 95% confidence interval [CI]: 0.4–1.0 vs. 0.2 events per year 95% CI: –0.02 to 0.5) and avoidance of treatment-related heart attack risk (1.4 severe hypoglycemic events per year; 95% CI: 0.8–1.9 vs. 1 event per year; 95% CI: 0.6–1.3). This finding is supported by a log-likelihood test that rejected at the 0.05 level that respondent preference structures are similar across the different experimental arms of the discrete-choice experiment.


We found evidence that benefit descriptions influence elicited preferences for the benefit-risk characteristics of injectable diabetes treatment. These findings argue for using carefully defined effectiveness measures to accurately take account of the patient perspective in benefit-risk assessments.
HEOR Topics :
Tags :
  • A
  • asymptomatic marker
  • discrete-choice experiment
  • health communication
  • long-term sequelae
  • severe outcome
  • stated preference research
  • technical terms
  • type 2 diabetes
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