Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado, Department of Internal Medicine, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado, Department of Pediatrics, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado, Editor-in-Chief, Diabetes Technology & Therapeutics.
[Show abstract][Hide abstract] ABSTRACT:
This study seeks to provide evidence for deciding whether or not a new preparation for the treatment of diabetes should be included in the benefit list of social health insurance. A discrete-choice experiment (DCE) was conducted in Germany to measure preferences for modern insulin therapy using long-acting insulin analogue “insulin detemir” in comparison to NPH insulin. The DCE contains two price attributes, co-payment and increased contributions to health insurance, as well as four properties of the insulin, i.e. risk of hypoglycemia, weight gain, need for preparing the insulin before injection, and flexibility in time of the injection. Of the 1,110 individuals interviewed in 2007, 202 suffered from type 1, 154 from insulin-treated type 2, and 152 from insulin-naive type 2 diabetes. This allows to compare ex-ante and ex-post willingness-to-pay (WTP). Non-diabetics and insulin-naive diabetics exhibit higher WTP values through co-payment, while affected type 1 and insulin-treated type 2 diabetics have higher WTP through increased contributions. However, WTP values exceed the extra treatment cost in both financing alternatives, justifying inclusion of the new drug in the benefit list from a cost-benefit point of view.
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