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Does Diabetes Have an Impact on Health-State Utility? A Study of Asians in Singapore

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Abstract

Objective

Our objective was to compare the time trade-off (TTO) values of EQ-5D-3L health states elicited from Singaporeans with and without type 2 diabetes mellitus (T2DM) and T2DM patients with and without complications.

Methods

The TTO values of ten EQ-5D-3L health states were elicited from a consecutive sample of T2DM patients and a general Singaporean population sample using similar valuation protocols. In face-to-face interviews, T2DM patients and members of the general population were asked to value five and ten health states, respectively. The difference in TTO values between the two samples and between T2DM patients with and without complications was examined using multiple linear regression models.

Results

A total of 109 T2DM patients and 46 individuals without T2DM provided data. All ten health states considered, the mean TTO value was −0.02 for the general population sample and −0.04 for T2DM patients, with the unadjusted and adjusted difference being −0.06 (95 % confidence interval [CI] −0.16, 0.03) and 0.02 (95 % CI −0.12, 0.15). The general population sample had systematically lower TTO values for mild health states, with the adjusted difference being −0.13 (95 % CI −0.25, −0.02); while the two samples had similar TTO values for severe health states, with the adjusted difference being 0.02 (95 % CI −0.16, 0.19). T2DM patients without complications had systematically lower TTO values than those with complications, with the adjusted difference being −0.10 (95 % CI −0.23, 0.03).

Conclusions

It appears that diabetes and its complications affect patients’ valuation of health states. Hence, the EQ-5D-3L health-state values based on the general population may underestimate the utility of health interventions for T2DM.

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Acknowledgments

This study was financially supported by the National University of Singapore.

All authors have no conflicts of interest that are relevant to the content of the study.

Authors’ contributions

Wang P: design of the study, data collection, analysis and interpretation of results, drafting of the article, and critical revision of the article for important intellectual content.

Tai ES: study coordination, critical revision of the article for important intellectual content.

Thumboo J: critical revision of the article for important intellectual content.

Vrijhoef HJM: critical revision of the article for important intellectual content.

Luo N: overall guarantor, design of the study, study coordination, interpretation of results, critical revision of the article for important intellectual content.

Author information

Authors and Affiliations

  1. Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Block MD3, Singapore, 117597, Singapore

    P. Wang, Hubertus J. M. Vrijhoef & Nan Luo

  2. Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore, Singapore

    E. S. Tai

  3. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore

    J. Thumboo

Authors
  1. P. Wang
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  2. E. S. Tai
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  3. J. Thumboo
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  4. Hubertus J. M. Vrijhoef
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  5. Nan Luo
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Corresponding author

Correspondence to Nan Luo.

Appendix

Appendix

See Tables 4 and 5.

Table 4 Parameter estimates of random-effects regression models of time trade-off values for patients with type 2 diabetes mellitus and participants from the general population
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Table 5 Parameter estimates of random-effects regression models of time trade-off values for patients with type 2 diabetes mellitus with and without complications
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Wang, P., Tai, E.S., Thumboo, J. et al. Does Diabetes Have an Impact on Health-State Utility? A Study of Asians in Singapore. Patient 7, 329–337 (2014). https://doi.org/10.1007/s40271-014-0059-y

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