I mproved glycemic control reduces the risk of long-term diabetes complications (1-3). However, subcutaneous insulin injections represent a barrier to achieving "optimal" blood glucose levels, particularly among type 2 diabetic patients (4). Indeed, some patients even delay initiation of therapy to avoid injections (5). This study used conjoint analysis to quantify the relative importance that Canadian patients with type 2 diabetes place on short-term treatment outcomes and on the frequency of insulin injections. RESEARCH DESIGN AND METHODS-A total of 1,886 patients enrolled in a Canadian consumer panel (n ϭ 70,000) were mailed a questionnaire. Study entry criteria were age Ն18 years and self-reported type 2 diabetes. The choice format conjoint questionnaire was designed to reveal the relative importance patients place on various health outcomes and treatment attributes associated with insulin therapy. This format offers advantages over other methods of quantifying health care preferences (6-11). The questions comprised 12 hypothetical treatment choices, including varying numbers of daily insulin injections using an insulin pen (one to three injections), levels of glucose control (optimal, suboptimal, and poor as fasting plasma glucose levels of 4-7, 7.1-10, and Ͼ10 mmol/l, respectively), HbA 1c (A1C) levels Ͻ7, 7-8.4, and Ͼ8.4%), and numbers of mild-to-moderate hypoglycemic events per month (Ͻ1, 1-2, Ͼ2). Insulin

BackgroundThe World Health Organization has called for global and regional assessments of the burden of hepatitis C (HCV) along with country-specific patient profiles to better inform healthcare policy. The present investigated the characteristics and burden of patients reporting a diagnosis of HCV infection in the US, France, Germany, Italy, Spain, the UK, urban China, and Japan using a consistent methodology of patient-reported surveys.MethodsThe 2010 5EU (N = 57,805), 2009 US (N = 75,000), 2008/2009 Japan (N = 37,683), and 2009/2010 urban China (N = 33,261) waves of the National Health and Wellness Survey were used as the data source. Within each country, patients with a self-reported diagnosis of HCV were compared with those who did not report a diagnosis of HCV on sociodemographics, health behaviors, comorbidities, and health outcomes (e.g., Short Form-12v2). The effect of HCV was examined using regression analysis applying sampling weights.ResultsThe prevalence of HCV ranged from 0.26% (China) to 1.42% (Italy). Patients in Japan and Italy (61.60 and 61.02 years, respectively) were the oldest, while patients in the US were the most likely to be obese (39.31%) and have concomitant anxiety (38.43%) and depression (46.05%) compared with other countries. Pooling countries and adjusting for sociodemographics, health behaviors, and comorbidities, HCV was associated with significantly lower physical component summary scores (b = −2.51) and health utilities (b = −0.04) and greater overall work impairment (b = 8.79), physician visits (b = 2.91), and emergency department visits (b = 0.30) (all p<.05). The effects on health status were strongest in the US and UK while the effects on healthcare resource use were strongest in Japan.ConclusionsHCV was associated with a significant humanistic and economic burden. These results suggest that the manifestation of the HCV burden, and the profile of the patients themselves, varied dramatically by country. Successful disease management should be cognizant of region-specific unmet needs.

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Dementia rates increase with age; 1 an analysis of 22 studies reported a doubling of dementia prevalence rates every 5.1 years until the age of 95. 2 The yearly incidence of dementia in Canada, among individuals aged 65 years and older, is estimated at 19.1/1000 for men and 21.8/1000 for women. 3 The prevalence of dementia is expected to increase over the next decades, as a result of the aging population.

The results indicate that atazanavir/r is cost-saving and more effective compared to lopinavir/r for patients who have previously not been exposed to antiretroviral drugs in Sweden.