Utilities and disutilities for type 2 diabetes treatment-related attributes

Qual Life Res. 2007 Sep;16(7):1251-65. doi: 10.1007/s11136-007-9226-0. Epub 2007 Jul 19.


Introduction: Although cost-utility analyses are frequently used to estimate treatment outcomes for type 2 diabetes, utilities are not available for key medication-related attributes. The purpose of this study was to identify the utility or disutility of diabetes medication-related attributes (weight change, gastrointestinal side effects, fear of hypoglycemia) that may influence patient preference.

Methods: Patients with type 2 diabetes in Scotland and England completed standard gamble (SG) interviews to assess utility of hypothetical health states and their own current health state. The EQ-5D, PGWB, and Appraisal of Diabetes Symptoms were administered. Construct validity and differences among health states were examined with correlations, t-tests, and ANOVAs.

Results: A total of 129 patients (51 Scotland; 78 England) completed interviews. Mean utility of diabetes without complications was 0.89. Greater body weight was associated with disutility, and lower body weight with added utility (e.g., 3% higher = -0.04; 3% lower = +0.02). Gastrointestinal side effects and fear of hypoglycemia were associated with significant disutility (p < 0.001). SG utility of current health (mean = 0.87) demonstrated construct validity through correlations with patient-reported outcome measures (r = 0.08-0.31).

Discussion: The vignette-based approach was feasible and useful for assessing added utility or disutility of medication-related attributes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Body Weight
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / economics
  • England
  • Feasibility Studies
  • Female
  • Health Status Indicators
  • Health Status*
  • Humans
  • Hypoglycemia / psychology
  • Hypoglycemic Agents / therapeutic use*
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Scotland
  • Treatment Outcome*


  • Hypoglycemic Agents