Health utility of type 2 diabetes patients using basal insulin in China: results from the BEYOND II study
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ORIGINAL ARTICLE
Health utility of type 2 diabetes patients using basal insulin in China: results from the BEYOND II study Chaoyun Li1 · HuiJun Zhou2 · Pei Wang3,4 Received: 29 July 2020 / Accepted: 5 October 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020
Abstract Objective To derive the health utility scores of type 2 diabetes (T2D) patients using basal insulin (BI) with diverse characteristics in China. Methods The study used the data of insulin-using T2D patients on BI treatment enrolled in the BEYOND II study, which is a multi-center, observational study from 78 hospitals nationwide. The 3-level EQ-5D (EQ-5D-3L) questionnaire was administered to each patient to derive their health utility scores using the EQ-5D-3L value set for China. Patients’ clinical and sociodemographic information were retrieved from their electronic case report form (eCRF). Ordinary least-square models with different specifications were explored to identify the best-fitting model to predict the utility scores. Results The sample (n = 12,583) achieved a mean (standard deviation) EQ-5D-3L utility score of 0.936 (0.120). According to the model, a Chinese male who was younger than 59 years, not underweight, diagnosed with T2D shorter than 10 years, with controlled plasma glucose and free of diabetes complications/comorbidities, would have a mean utility of 0.993. Being female, older age, underweight, and higher plasma glucose, longer diabetes duration was negatively related to EQ-5D-3L scores. Comorbidities and seven of eleven complications were associated with utility decrement. Interactions between some complications were also discovered. Conclusions The derived health utility scores for diabetes complications could facilitate the assessment of the cost-effectiveness of health interventions for Chinese insulin-using T2D patients. Keywords Type 2 diabetes · Complications · Utility · Insulin · EQ-5D
Introduction
This article belongs to the topical collection Health Education and Psycho-Social Aspects, managed by Massimo Porta and Marina Trento. * Pei Wang [email protected] 1
Health Economics and Outcome Research, Sanofi, Shanghai, China
2
Department of Public AdministrationBusiness School, University of Shanghai for Science and Technology, Shanghai, China
3
School of Public Health, Fudan University, 130 Dong An Road, Shanghai 200032, China
4
Key Lab of Health Technology Assessment, National Health Commission of the People’s Republic of China (Fudan University), Shanghai, China
The prevalence of diabetes in China has dramatically increased from 4.5% in 2010 to 10.9% in 2019 in adults 20–79 years [1]. According to a nation survey, China has the largest number of adult diabetic patients (113.9 million) in the world [2]. The expenditure for diabetes in Chinese adult patients was estimated to be $110 billion in 2017 [1]. Insulin-based therapy is an important treatment regimen for diabetes but with the impact of health-related quality of life (HRQOL) [3]. More than one-third of diabetic patients in C
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