Health State Utilities Associated with Attributes of Weekly Injection Devices and Subdermal Implant for Treatment of Type 2 Diabetes

Cost-utility analyses include health utilities to compare medical treatments. Health utilities, ranging from 0 to 1, represent the strength of a patient’s preference for a drug profile or health-related outcome. Recently glucagon-like peptide-1 (GLP-1) receptor agonists have been used for management of glycemic control in type 2 diabetes (T2DM). Many GLP-1 drugs have similar modes of administration. In contrast, ITCA 650 is an investigational product which is an implantable device that, following subdermal placement, provides continuous delivery of exenatide for 3 or 6 months. The study’s purpose was to estimate health utilities associated with treatment processes of GLP-1s for use in economic models. During a UK-based pilot study, 19 general population (general population) participants completed time trade-off (TTO) interviews to value health states (often called vignettes or scenarios) which were based on literature review, instructions for use, and clinician interviews. A follow-up pilot study was conducted in both general population and T2DM participants to value modified health states. Participants were recruited to ensure equal distribution across gender and education levels. A total of 20 general population and 18 T2DM patients completed face-to-face interviews (general population mean age= 50.7; T2DM mean age = 56.2). Mean utilities (SD) for ITCA-650 were 0.93 (0.06) for T2DM patients and 0.91 (0.11) for the general population. Mean utility scores for injection health states ranged from 0.83-0.92 for T2DM and 0.82-0.91 for general population. Results are higher than others found in the literature for diabetes treatment processes (range: 0.85 to 0.88). A main study with 200 participants will be conducted in early 2018. Results may be useful in cost-utility models comparing the value of treatment processes for patients with T2DM. Findings suggest the TTO method may be used to quantify preferences among different treatment processes.