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A valuation of patients' willingness-to-pay for insulin delivery in diabetes

Published online by Cambridge University Press:  21 July 2009

Camila Guimarães ,
Carlo A. Marra ,
Lindsey Colley ,
Sabrina Gill ,
Scot H. Simpson ,
Graydon S. Meneilly ,
Regina H. C. Queiroz  and
Larry D. Lynd
Camila Guimarães
Affiliation:
University of São Paulo
Carlo A. Marra
Affiliation:
University of British Columbia
Lindsey Colley
Affiliation:
University of British Columbia
Sabrina Gill
Affiliation:
University of British Columbia
Scot H. Simpson
Affiliation:
University of Alberta
Graydon S. Meneilly
Affiliation:
University of British Columbia
Regina H. C. Queiroz
Affiliation:
University of São Paulo
Larry D. Lynd
Affiliation:
University of British Columbia
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Abstract

Objectives: The aim of this study was to determine the insulin-delivery system and the attributes of insulin therapy that best meet patients' preferences, and to estimate patients' willingness-to-pay (WTP) for them.

Methods: This was a cross-sectional discrete choice experiment (DCE) study involving 378 Canadian patients with type 1 or type 2 diabetes. Patients were asked to choose between two hypothetical insulin treatment options made up of different combinations of the attribute levels. Regression coefficients derived using conditional logit models were used to calculate patients' WTP. Stratification of the sample was performed to evaluate WTP by predefined subgroups.

Results: A total of 274 patients successfully completed the survey. Overall, patients were willing to pay the most for better blood glucose control followed by weight gain. Surprisingly, route of insulin administration was the least important attribute overall. Segmented models indicated that insulin naïve diabetics were willing to pay significantly more for both oral and inhaled short-acting insulin compared with insulin users. Surprisingly, type 1 diabetics were willing to pay $C11.53 for subcutaneous short-acting insulin, while type 2 diabetics were willing to pay $C47.23 to avoid subcutaneous short-acting insulin (p < .05). These findings support the hypothesis of a psychological barrier to initiating insulin therapy, but once that this barrier has been overcome, they accommodate and accept injectable therapy as a treatment option.

Conclusions: By understanding and addressing patients' preferences for insulin therapy, diabetes educators can use this information to find an optimal treatment approach for each individual patient, which may ultimately lead to improved control, through improved compliance, and better diabetes outcomes.

Keywords

Willingness-to-payDiscrete choice experimentInsulin therapyDiabetesPatients' preferences
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 3 , July 2009 , pp. 359 - 366
Copyright
Copyright © Cambridge University Press 2009

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