Utility values for symptomatic non-severe hypoglycaemia elicited from persons with and without diabetes in Canada and the United Kingdom

Adrian R Levy¹^,2^,3 , Torsten LU Christensen⁴ and Jeffrey A Johnson⁵

¹Oxford Outcomes Ltd., Vancouver, BC, Canada

²University of British Columbia, Vancouver, BC, Canada

³Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada

⁴Novo Nordisk A/S, Denmark

⁵School of Public Health, University of Alberta, Edmonton, Alberta, Canada

author email corresponding author email

Health and Quality of Life Outcomes 2008, 6:73doi:10.1186/1477-7525-6-73


Published:	29 September 2008

Abstract

Objective

To elicit societal and patient utilities associated with diabetic symptomatic non-severe hypoglycaemia for three health states: 1) rare (quarterly), 2) intermittent (monthly), 3) and frequent (weekly) hypoglycaemia episodes.

Methods

Using validated health states, time trade-off utilities were elicited from 51 Canadian respondents with diabetes, and 79 respondents in Canada and 75 respondents in the United Kingdom (UK) without diabetes.

Results and discussion

Each hypoglycaemic episode was associated with a reduction in utility and persons with diabetes consistently reported slightly higher utility values than respondents without diabetes. The utility for diabetes without hypoglycaemia ranged from 0.88 to 0.97, the mean utility for rare hypoglycaemic events (quarterly) ranged between 0.85 and 0.94. The utility for the intermittent state (monthly) ranged from 0.77 to 0.90 and from 0.66 to 0.0.83 for the frequent state (weekly). Differences were observed between respondents without diabetes in Canada and the UK. Using a multivariate linear OLS regression, the estimated utilities associated with a single hypoglycaemic event were -0.0033 and -0.0032 for respondents with diabetes and without diabetes, respectively.

Conclusion

Among respondents with and without diabetes, there was a demonstrable utility loss associated with hypoglycaemia. Considering a utility loss of 0.03 as a minimum clinically important difference for persons with diabetes, the evidence from this study indicates that as low as ten symptomatic non-severe hypoglycaemic episodes per year may be of clinical importance and that the importance increases with frequency of episodes. Integrating directly elicited utility values such as those reported here will improve the quality and applicability of economic evaluations of diabetes treatment.