Is There Any Difference in Preferences Between Patients and Physicians? Evidence From Anti-Hyperglycemic Medications Choices for Type 2 Diabetes.

Abstract

Aims: This study aimed to explore differences in preferences between Chinese patients with type 2 diabetes mellitus (T2D) and physicians when selecting anti-hyperglycemic medications.

Materials and methods: We conducted a discrete choice experiment (DCE) involving 1784 patients (face-to-face surveys) and 168 physicians (online questionnaires) across eastern, central, and western China. Seven treatment attributes were assessed: HbA1c reduction, hypoglycemia risk, cardiovascular benefits, gastrointestinal adverse events, weight change, mode of administration, and monthly out-of-pocket cost. Preference heterogeneity was explored using latent class model.

Results: Patients placed the greatest importance on monthly out-of-pocket cost, treatment efficacy, and hypoglycemia risk, whereas physicians prioritized hypoglycemia risk, cardiovascular benefits, and treatment efficacy. Notably, physicians tended to overestimate patients' willingness to pay for treatment benefits. Specifically, patients were willing to pay 277 CNY (39 USD) for cardiovascular benefits, whereas physicians estimated that patients would be willing to pay 864 CNY (121 USD). Latent class analysis identified substantial heterogeneity in both groups. In particular, the largest patient subgroup was strongly cost-sensitive, with preferences driven primarily by financial burden, whereas no directly corresponding physician subgroup was observed.

Conclusion: Patients and physicians differ in how they prioritize diabetes medication attributes, especially regarding efficacy, cardiovascular benefit, and cost. Shared decision-making should account for these differences to support value-concordant, patient-centered diabetes care.