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  • Diabetes patient preferences for glucose-monitoring technologies: results from a discrete choice experiment in Poland and the Netherlands

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Emerging technologies, pharmacology and therapeutics
Diabetes patient preferences for glucose-monitoring technologies: results from a discrete choice experiment in Poland and the Netherlands
  1. Ian P Smith1,
  2. Chiara L Whichello2,3,4,
  3. Jorien Veldwijk1,3,4,
  4. Maureen P M H Rutten-van Mölken3,
  5. C G M Groothuis-Oudshoorn5,
  6. Rimke C Vos6,
  7. Esther W de Bekker-Grob3,4,
  8. G Ardine de Wit1
  1. 1Healthcare Innovation and Evaluation, University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
  2. 2Evidera, London, UK
  3. 3Erasmus School of Health Policy and Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
  4. 4Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
  5. 5Health Technology and Services Research (HTSR), Faculty of Behavioural Management and Social Sciences, University of Twente, Enschede, The Netherlands
  6. 6Public Health and Primary Care/LUMC Campus The Hague, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Ian P Smith; i.p.smith{at}umcutrecht.nl

Abstract

Introduction New glucose-monitoring technologies have different cost–benefit profiles compared with traditional finger-prick tests, resulting in a preference-sensitive situation for patients. This study aimed to assess the relative value adults with diabetes assign to device attributes in two countries.

Research design and methods Adults with type 1 or 2 diabetes from the Netherlands (n=226) and Poland (n=261) completed an online discrete choice experiment. Respondents choose between hypothetical glucose monitors described using seven attributes: precision, effort to check, number of finger pricks required, risk of skin irritation, information provided, alarm function and out-of-pocket costs. Panel mixed logit models were used to determine attribute relative importance and to calculate expected uptake rates and willingness to pay (WTP).

Results The most important attribute for both countries was monthly out-of-pocket costs. Polish respondents were more likely than Dutch respondents to choose a glucose-monitoring device over a standard finger prick and had higher WTP for a device. Dutch respondents had higher WTP for device improvements in an effort to check and reduce the number of finger pricks a device requires.

Conclusion Costs are the primary concern of patients in both countries when choosing a glucose monitor and would likely hamper real-world uptake. The costs-benefit profiles of such devices should be critically reviewed.

  • patient-centered care
  • blood glucose self-monitoring
  • economics

Data availability statement

Data are available upon reasonable request.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2022-003025

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors IPS, CLW, JV, MPMHR-vM, RCV, EWdB-G and GAdW were responsible for the initial development, set-up and design of the study. IPS and CLW were responsible for the qualitative aspects of the study as well as quantitative data collection under the direct supervision of GAdW, JV, EWdB-G, and MPMHR-vM. The primary analysis was conducted by IPS with assistance from JV and CGMG-O. All authors reviewed the final manuscript and contributed to the revisions. IPS is the guarantor for this articla and accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding This study formed part of the Patient Preferences in Benefit-Risk Assessments during the Drug Life Cycle (PREFER) project. The PREFER project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement number 115966). This joint undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.