Objective: Previous studies have examined health state utilities (which are preference weightings for use in cost-effectiveness analyses) associated with injectable GLP-1 receptor agonists for treatment of type 2 diabetes (T2D). An oral formulation of semaglutide (sema) has recently become available. This study estimates health state utilities representing preferences associated with routes of administration for daily oral sema and two weekly injectable GLP-1 receptor agonists.

Methods: Participants with T2D in the UK valued four health state vignettes (drafted based on drug labels and device instructions for use) in time trade-off interviews to estimate preference-based utility scores. The vignettes had identical descriptions of T2D, but differed in treatment process: (1) daily simple oral treatment (tablets without specific administration requirements), (2) daily oral sema (tablet with administration requirements per product label), (3) weekly dulaglutide (dula) injection, (4) weekly sema injection.

Results: Interviews were completed by 201 participants (52.7% male; mean age=58.7). Preferences among routes of administration varied widely. Mean utilities were 0.890 for simple oral, 0.880 for oral sema, 0.878 for dula injection, and 0.859 for sema injection (with higher scores indicating greater preference). All pairwise comparisons found statistically significant differences among the four utility scores (p<0.01), except the comparison between oral sema and dula which was not significant (p=0.49).

Conclusions: While some participants preferred daily oral treatment, others preferred one of the weekly injections. Results suggest that patient preferences for routes of administration cannot be compared using only the simplest descriptions (e.g., “oral” vs. “injectable”). The details of treatment administration and treatment frequency have an impact on preference and should be considered.


K. Boye: Employee; Self; Lilly Diabetes. Stock/Shareholder; Self; Eli Lilly and Company. K. Cutts: Employee; Self; Evidera. K. Stewart: Employee; Self; Evidera. K. Norrbacka: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. L.E. García-Pérez: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. L.S. Matza: Employee; Self; Evidera.

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