Willingness to pay for health improvements associated with anti-diabetes treatments for people with type 2 diabetes

Abstract

Objectives:

This study aimed to investigate the most important consequences of diabetes medication, as measured by the patients’ willingness to pay (WTP).

Research design and methods:

People in Sweden were recruited using existing nationwide e-mail panels if they were adults (≥18 years) with type 2 diabetes and were receiving pharmacological anti-diabetes treatment(s). Data were collected electronically and results were analysed using a standard statistical model designed for choice games (conditional logit). Six characteristics relating to treatment of diabetes were examined: weight (gain or loss), mean glycated haemoglobin level (HbA_1c), hypoglycaemic events, nausea, need for injections (with or independently of meals), and blood glucose testing.

Results:

A total of 461 people with type 2 diabetes (291 males; 170 females) completed an internet questionnaire and were eligible for inclusion. Participants placed high value on weight loss and nausea avoidance; they would pay 176 Swedish Krona (SEK)/€15.61 per month to lose 1 kg, and would pay SEK 560 (€49.67) per month to avoid nausea completely. Patients wanting to reduce the number of hypoglycaemic events from three per month to none were willing to pay SEK 419 (€37.17) per month. Patients valued a 1 percentage point reduction in HbA_1c at SEK 414 (€36.72) per month. Participants preferred taking tablets to injections and required a compensation of SEK 376 (€33.35) to accept one injection/day. Injections independent of meals were preferred to injections with meals (WTP: SEK 140/€12.42 per month). Potential limitations of this study are that the preferences expressed may not match preferences in real-life situations, and bias through the use of electronic questionnaire, which restricted participation to those with access to, and experience with, the internet.

Conclusion:

People with type 2 diabetes were willing to pay a considerable amount of money each month to lose weight, reduce or avoid hypoglycaemic events and reduce HbA_1C.

Key words::

• Diabetes
• Discrete choice experiment
• HbA_1c
• Hypoglycaemia
• Patient preference
• Willingness to pay
• Weight

Transparency

Declaration of funding

This survey and this paper was sponsored and supported by Novo Nordisk A/S (Bagsværd, Denmark).

Declaration of financial/other relationships

J.J., M.R. and O.T. have disclosed that they are involved in Novo Nordisk advisory boards. J.J., M.R. and O.T. have disclosed that they have no other competing interests to declare. M.L. has disclosed that he is employed by Novo Nordisk Scandinavia and holds Novo Nordisk A/S stock shares. Å.E. has disclosed that she is employed by Novo Nordisk Scandinavia. M.B. has no disclosures to declare.

Acknowledgements

This paper received editorial support from ESP Bioscience (Sandhurst, UK).