评估中国 2 型糖尿病患者对口服抗糖尿病药物的偏好和支付意愿:离散选择实验

Ling-Hsiang Chuang, Huanlan Zhang, Tianqi Hong, Shitong Xie
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摘要

目的 量化中国 2 型糖尿病(T2DM)患者对口服抗糖尿病药物(OAD)的偏好。方法 在从线上和线下招募的 T2DM 患者中开展了一项假设 OAD 特征的离散选择实验(DCE)。每位患者完成了 12 项离散选择实验任务。通过混合方法得出的属性包括血糖水平下降、血糖水平稳定、用药频率、胃肠道副作用、剂量调整和自付费用。采用条件对数回归模型对数据进行分析。同时还计算了患者的支付意愿(WTP)。结果 共有 741 名受访者被纳入分析样本,其中在线受访者 456 人,离线受访者 285 人。结果显示,除剂量调整属性中的 "肝肾功能不全患者需调整剂量 "这一水平外,其他所有属性和水平均具有统计学意义。WTP 结果显示,患者愿意分别支付 12.06 元和 23.20 元,将用药频率从 "每天一次 "和 "每天三次 "减少到 "每两周一次"。亚组分析表明,用药次数(每天一次与每天两到三次)的影响最大,对系数估计的影响也最大。结果表明,中国 T2DM 患者优先考虑的是 OAD 治疗的疗效更好、用药次数更少、胃肠道副作用更小、肝肾功能不全患者无需调整剂量以及自付费用更低。
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Evaluating the Preferences and Willingness-to-Pay for Oral Antidiabetic Drugs Among Patients with Type 2 Diabetes Mellitus in China: A Discrete Choice Experiment

Purpose

To quantify the preferences for an oral antidiabetic drug (OAD) among patients with type 2 diabetes mellitus (T2DM) in China.

Methods

A discrete choice experiment (DCE) with hypothetical OAD profiles was performed among patients with T2DM recruited from both online and offline sources. Each patient completed 12 DCE choice tasks. The attributes, elicited through mixed methods, include blood glucose level decrease, blood glucose level stability, frequency of medication, gastrointestinal side effects, dose adjustment and out-of-pocket expense. The conditional logit regression model was used to analyze the data. Patients’ willingness-to-pay (WTP) was also calculated. Subgroup analyses based on patient characteristics were also conducted.

Results

A total of 741 respondents were included in the analysis sample, covering 456 respondents online and 285 offline. The result showed that all attributes and levels were statistically significant, except one level “dose adjustment required for patients with hepatic or renal insufficiency” in the attribute of dose adjustment. WTP results showed that patients were willing to pay 12.06 and 23.20 yuan, respectively to reduce the frequency of medication from “once per day” and “three times per day” to “once every 2 weeks”, respectively. Subgroup analyses showed that the frequency of medication (once versus two to three times per day) had the largest impact and influenced most coefficient estimates.

Conclusion

The results suggest that Chinese patients with T2DM prioritized better efficacy, less frequency of medication, lower gastrointestinal side effects, no dose adjustment required for patients with hepatic or renal insufficiency, and less out-of-pocket expense of OAD treatment.

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