Patient Preference and Adherence (Dec 2022)
Patients’ Preferences for Sodium-Glucose Cotransporter 2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists
Abstract
Bidur Banjara,1,2 Nabin Poudel,1 Kimberly B Garza,1 Salisa Westrick,1 Heather P Whitley,3 David Redden,4 Surachat Ngorsuraches1 1Department of Health Outcomes Research and Policy, Auburn University, Harrison College of Pharmacy, Auburn, AL, USA; 2Cytel Inc, Waltham, MA, USA; 3Department of Pharmacy Practice, Auburn University, Harrison College of Pharmacy, Auburn, AL, USA; 4Department of Biomedical Affairs and Research, Auburn University, Edward via College of Osteopathic Medicine, Auburn, AL, USACorrespondence: Surachat Ngorsuraches, Department of Health Outcomes Research and Policy, Auburn University, Harrison College of Pharmacy, 4306A Walker Building, Auburn, AL, 36849, USA, Tel +1 334 844 8357, Fax +1 334 844 8307, Email [email protected]: To determine patients’ preferences for sodium-glucose cotransporter 2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs).Patients and Methods: A cross-sectional, web-based discrete choice experiment was conducted among US adults with type 2 diabetes mellitus (T2DM) in May 2021. Six attributes—the route and frequency of administration, the chance of reaching target HbA1c in six months, the percentage reduction in the risk of major adverse cardiovascular events (MACE), the chance of gastrointestinal side effects, the chance of genital infection, and out-of-pocket cost per month—were identified from literature review and consultation with patients and clinicians. A Bayesian efficient design was used to generate choice sets. Each choice set contained two hypothetical SGLT-2i and GLP-1 RA alternatives described by the attributes and an opt-out alternative. A total of 176 patients were asked to select the most preferred option from each choice set. Mixed logit (ML) and latent class (LC) models were developed. The conditional relative importance of each attribute was determined.Results: The ML model showed the out-of-pocket cost had the highest conditional relative importance, followed by the chance of reaching the target HbA1c. The best LC model revealed two patient classes. All attributes were significantly important to the patients in both classes, except the chance of genital infection in class 2. Compared to the patients in class 2, the patients in class 1 were older (approximately 65 vs 56 years) and had a higher number of comorbidities (approximately three vs two).Conclusion: T2DM patients placed different preference weights or importance across SGLT-2i and GLP-1 RA attributes. Preference heterogeneity was found among patients with different ages and numbers of comorbidities.Keywords: diabetes, discrete choice experiment, patient preference, second-line antihyperglycemic agents
