Evaluating preferences for profiles of GLP-1 receptor agonists among injection-naïve type 2 diabetes patients in the UK

Figures & data

Table 1 Attributes and levels for the discrete choice experiment

Attribute	Levels
Dosing frequency	• Once a day (365 times per year)1 • Once a week (52 times per year)2
Blood sugar (HbA1c) change	• 67.9% of patients taking the medication reach their desired blood sugar (HbA1c) goals of less than 7%1 • 68.3% of patients taking the medication reach their desired blood sugar (HbA1c) goals of less than 7%2
Weight change	• Patients experience an average weight loss of 2.90 kg after the first 6 months of medication use2 • Patients experience an average weight loss of 3.61 kg after the first 6 months of medication use1
Type of delivery system	• Single-use prefilled pen ready for injection2 • Multidose prefilled pen, used with disposable injection needles, dosage selection required1
Frequency of nausea	• 20.4% of patients experience nausea anytime in the first 6 months of treatment2 • 18.0% of patients experience nausea anytime in the first 6 months of treatment1
Frequency of low blood sugar (hypoglycemia)	• On average, a patient would experience one low blood sugar (hypoglycemia) event every 2 years1 • On average, a patient would experience one low blood sugar (hypoglycemia) event every 3 years2

Notes:

1 Level representing liraglutide

2 Level representing dulaglutide.

Abbreviation: HbA_1c, hemoglobin A_1c.

Table 3 Part-worth utilities, RI, and rankings of attributes in overall sample

Parameter	Attribute levels	Part-worth utility estimate (SE)1	P-value2	Overall part-worth utility value3	RI4 (%)	Rank
Dosing frequency	Once a day (365 times per year)	−0.461 (0.042)	<0.0001	0.92	41.6	1
	Once a week (52 times per year)	0.461 (0.042)	<0.0001
Type of delivery system	Multidose prefilled pen	−0.393 (0.042)	<0.0001	0.79	35.5	2
	Single-use prefilled pen	0.393 (0.042)	<0.0001
Frequency of nausea	20.4% experience nausea	−0.115 (0.022)	<0.0001	0.23	10.4	3
	18.0% experience nausea	0.115 (0.022)	<0.0001
Weight change	2.90 kg weight loss	−0.066 (0.022)	0.0023	0.13	5.9	4
	3.61 kg weight loss	0.066 (0.022)	0.0023
Blood sugar (HbA1c) change	67.9% at goal	−0.040 (0.015)	0.0095	0.08	3.6	5
	68.3% at goal	0.040 (0.015)	0.0095
Frequency of low blood sugar events (hypoglycemia)	Once every 2 years	−0.033 (0.021)	0.1283	0.07	3.0	6
	Once every 3 years	0.033 (0.021)	0.1283

Notes:

1 Part-worth utility values provide information on the extent to which participants prefer each level of an attribute and are scaled within each attribute to have a mean of 0. A positive part-worth utility value indicates that the attribute level is preferred, while negative values indicate a preference for other levels of the attribute.

2 The P-values indicate whether the part-worth utility value differs significantly from 0.

3 The overall utility values represent the range of utility values within each attribute.

4 $\text{RI for each attribute}=\frac{\text{Overall utility value for each attribute}}{\text{Total utility value}}$, where total utility value = sum of overall utility values across all attributes.

Abbreviations: HbA_1c, hemoglobin A_1c; RI, relative importance; SE, standard error.

Figure 1 Participant disposition.

Note: *Excludes participants unwilling/unable to travel to interview location, no shows, and cancellations.
Abbreviation: T2DM, type 2 diabetes mellitus.

Table 2 Self-reported sociodemographic and clinical characteristics

	Overall sample N=243
Sex n (%)
Male	185 (76.1)
Female	58 (23.9)
Age in years, mean (SD) [range]	60.5 (10.9) [21–88]
Age group n (%)
18–29	2 (0.8)
30–39	5 (2.1)
40–49	30 (12.3)
50–64	113 (46.5)
65+	93 (38.3)
Race/ethnicity n (%)
White	175 (72.0)
Mixed/multiple ethnic groups	7 (2.9)
Asian or Asian-British	37 (15.2)
Black/African/Caribbean/Black British	23 (9.5)
Other	1 (0.4)
Employment status n (%)
Full-time	67 (27.7)
Part-time	31 (12.8)
Homemaker/housewife	5 (2.1)
Student	3 (1.2)
Unemployed	26 (10.7)
Retired	102 (42.1)
Disabled	8 (3.3)
Education n (%)
No formal qualifications	30 (12.4)
GCSE/‘O’ levels or equivalent	43 (17.8)
‘A’ levels or equivalent	48 (19.8)
Vocational/work-based qualifications	48 (19.8)
University degree	40 (16.5)
Postgraduate degree	33 (13.6)
Household income n (%)
Less than £5,200	8 (3.3)
£5,200 to £10,399	16 (6.6)
£10,400 to £15,599	25 (10.3)
£15,600 to £20,799	28 (11.5)
£20,800 to £25,999	16 (6.6)
£26,000 to £31,199	22 (9.1)
£31,200 to £36,399	17 (7.0)
£36,400 to £51,999	23 (9.5)
£52,000 or more	26 (10.7)
Missing	62 (25.5)
Height (cm), mean (SD) [range]	172.5 (9.7) [150–196]
Weight (kg), mean (SD) [range]	88.7 (17.3) [48–162]
BMI (kg/m2), mean (SD) [range]	29.8 (5.4) [18–52]
Duration of T2DM n (%)
Less than 1 year	14 (5.8)
More than 1 year and up to 5 years	87 (35.8)
More than 5 years and up to 10 years	84 (34.6)
More than 10 years	58 (23.9)
Current T2DM treatment n (%)
One oral diabetes medication only	109 (44.9)
Two oral diabetes medication only	75 (30.9)
Three or more oral diabetes medication	59 (24.3)
Current HbA1c level n (%)
Below 53 mmol/mol (below 7%)	70 (28.8)
Between 54 and 64 mmol/mol (between 7.1% and 8%)	62 (25.5)
Between 65 and 75 mmol/mol (between 8.1% and 9%)	27 (11.1)
Higher than 75 mmol/mol (higher than 9%)	16 (6.6)
Do not know	68 (28.0)

Abbreviations: BMI, body mass index; HbA_1c, hemoglobin A_1c; SD, standard deviation; T2DM, type 2 diabetes mellitus.

Figure 2 Relative importance of attributes in overall sample.

Abbreviation: RI, relative importance.

Figure 3 Relative importance of attributes by sex.

Notes: *Statistically significant difference between sexes in preference for levels of the attribute (P<0.05). **Statistically significant difference in the relative importance of each attribute across sex (P<0.0001).
Abbreviation: RI, relative importance.

Figure 4 Relative importance of attributes by age group (<60 years vs ≥60 years).

Notes: *Statistically significant difference between age groups in preference for levels of the attribute (P<0.05). **Statistically significant difference in the relative importance of each attribute across age groups (P=0.0108).
Abbreviation: RI, relative importance.