Preferences, Expectations and Attitudes on Basal Insulin from Patient–Physician–Payer Perspective: A Multi-stakeholder Survey by the Italian Diabetes Society (ITA4P Study)

Introduction: Diabetes management often involves complex insulin regimens, posing significant challenges for patients and healthcare systems. Weekly basal insulin formulations aim to simplify treatment, reduce injection frequency, and improve adherence and quality of life. This study explored the beliefs, preferences and attitudes of patients, physicians and payers regarding current basal insulin therapy and weekly insulin formulations. Methods: An online survey with structured questionnaires was developed for multiple stakeholders: patients with type 1 or type 2 diabetes, physicians and payers. Participants provided self-reported insights into basal insulin therapy and perceptions of weekly formulations. Results are presented in a descriptive non-analytical way. Results: A total of 1094 patients, 468 physicians and 100 payers participated. Patients reported moderate satisfaction with current insulin therapy, with lower satisfaction in type 2 diabetes (T2D). The major burdens identified were daily injections and fear of hypoglycaemia, with weekly insulin seen as a promising alternative. Physicians prioritized glycaemic control goals, while patients emphasized independence and quality of life. Payers valued adherence and hypoglycaemia avoidance but raised concerns about costs and education needs. Conclusions: According to this multi-stakeholder survey, weekly basal insulin offers a promising approach to reduce treatment burden and improve adherence and quality of life. Addressing concerns about safety, efficacy and cost will be critical to its successful adoption in clinical practice.