OBJECTIVES: The importance of patient preference data is increasingly recognised by healthcare decision makers, supporting a patient-centered approach towards health technology assessment. This study explored type 2 diabetes (T2D) patient preferences for basal insulin treatment attributes to inform a discrete choice experiment (DCE).

METHODS: A review of clinical and patient-focused literature, basal insulin product labeling, and advisory panel feedback informed the development of a draft attributes and levels (A&L) grid of patient-relevant insulin treatment features. Sixty-minute combined concept elicitation (CE) and cognitive debriefing interviews were conducted with adult Canadian T2D patients receiving T2D treatment(s) (excluding basal-bolus insulin) to explore treatment preference drivers and assess understanding and relevance of the draft A&L grid.

RESULTS: Ten T2D patients (aged 22-73; 50:50 female:male; 4.6-18 years diagnosed) were interviewed. Of the ten treatment attributes identified from the literature review and/or CE section of interviews as relevant to patient insulin treatment decision-making, five were retained/incorporated into the final A&L grid (mode of administration n=10; frequency of administration n=10; dose timing n=10; risk of severe hypoglycemia n=7; dose monitoring n=5; where n=number of patients who mentioned attribute during the CE section). The remaining attributes identified were excluded from the final grid due to lack of differentiation across marketed insulin products (side effects n=6; weight control n=5) or lack of importance/relevance (cost n=1; injection hold time – identified in the literature review only). A&L grid wording was well understood; minor wording updates were implemented to enhance clarity.

CONCLUSIONS: The patient-centric approach employed in this study led to mode and frequency of administration, dose timing and monitoring, and risk of severe hypoglycemia being identified as potentially important treatment differentiators to T2D patients. The findings warrant further evaluation of the concepts in a DCE whereby the relative importance of frequency of administration in basal insulin treatment preferences of T2D patients is quantified.