A short-term cost-utility analysis of insulin degludec versus insulin glargine U100 in patients with type 1 or type 2 diabetes in Denmark

Pollock, Richard F; Tikkanen, Christian Klyver

doi:10.1080/13696998.2016.1245663

Cited by 16 publications

(18 citation statements)

References 28 publications

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“…The short‐term costs need to be assessed to determine if the long‐term benefit results in lower lifetime costs, taking quality of life, long‐term complications, and life expectancy into account. Given the reduced incidence of hypoglycemia, newer analogs may be even more cost‐effective Limited available information does allow some assessment of the outcome of current insulin analog regimens using SMBG in an affluent society with calculation of a projected cost:benefit ratio over the lifetime of an adolescent Reports suggest that basal‐bolus therapy and, more recently, insulin pump therapy produce better long‐term outcomes with a beneficial overall lifetime cost (weighing lifetime injection therapy using a multiple daily injection [MDI] regimen with NPH as the basal insulin vs insulin pump therapy) …”

Section: Cost Of Care and Cost Benefit Analysismentioning

confidence: 99%

“…Given the reduced incidence of hypoglycemia, newer analogs may be even more cost-effective. 131 • Limited available information does allow some assessment of the outcome of current insulin analog regimens using SMBG in an affluent society with calculation of a projected cost:benefit ratio over the lifetime of an adolescent…”

Section: Children With Diabetes In the School Settingmentioning

confidence: 99%

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ISPAD Clinical Practice Consensus Guidelines 2018: The delivery of ambulatory diabetes care to children and adolescents with diabetes

et al. 2018

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Section: Cost Of Care and Cost Benefit Analysismentioning

confidence: 99%

Section: Children With Diabetes In the School Settingmentioning

confidence: 99%

ISPAD Clinical Practice Consensus Guidelines 2018: The delivery of ambulatory diabetes care to children and adolescents with diabetes

et al. 2018

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“…Other CEAs of degludec vs glargine U100, from a public healthcare payer perspective, have reported similar findings; degludec is a dominant or cost‐effective treatment option in patients with T2D across treatment regimens, in each respective setting . To date, these have all been informed by data from phase 3, treat‐to‐target clinical trials that have focused on the short‐term effects of hypoglycaemia rates and insulin dosing over a 1‐year time horizon in a European setting .…”

Section: Discussionmentioning

confidence: 79%

“…17 Prior to the DEVOTE trial, CEAs of degludec compared with glargine U100 captured the effects of hypoglycaemia rates and insulin dosing over a short-term (1-year) time horizon in patients with type 1 (T1D) or type 2 (T2D) diabetes, based on the phase 3 clinical trial programme. [18][19][20][21][22][23] The DEVOTE trial provided an opportunity to evaluate randomized, double-blind clinical trial data, including cardiovascular endpoints and death, in addition to severe hypoglycaemia rates and insulin dosing, to provide health economic analyses of degludec vs glargine U100 over a 2-year time horizon without extrapolation.…”

Section: Introductionmentioning

confidence: 99%

Short‐term cost‐utility of degludec versus glargine U100 for patients with type 2 diabetes at high risk of hypoglycaemia and cardiovascular events: A Canadian setting (DEVOTE 9)

Pollock¹,

Heller

Pieber

et al. 2019

Diabetes Obesity Metabolism

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Aims To evaluate the short‐term cost‐effectiveness of insulin degludec (degludec) vs insulin glargine 100 units/mL (glargine U100) from a Canadian public healthcare payer perspective in patients with type 2 diabetes (T2D) who are at high risk of cardiovascular events and hypoglycaemia. Materials and methods A decision analytic model was developed to estimate costs (2017 Canadian dollars [CAD]) and clinical outcomes (quality‐adjusted life years [QALYs]) with degludec vs glargine U100 over a 2‐year time horizon. The model captured first major adverse cardiovascular event, death, severe hypoglycaemia and insulin dosing. Clinical outcomes were informed by a post hoc subgroup analysis of the DEVOTE trial (NCT01959529), which compared the cardiovascular safety of degludec and glargine U100 in patients with T2D who are at high cardiovascular risk. High hypoglycaemia risk was defined as the top quartile of patients (n = 1887) based on an index of baseline hypoglycaemia risk factors. Results In patients at high hypoglycaemia risk, degludec was associated with mean cost savings (CAD 129 per patient) relative to glargine U100, driven by a lower incidence of non‐fatal myocardial infarction, non‐fatal stroke and severe hypoglycaemia, which offset the slightly higher cost of treatment with degludec. A reduced risk of cardiovascular death and severe hypoglycaemia resulted in improved effectiveness (+0.0132 QALYs) with degludec relative to glargine U100. In sensitivity analyses, changes to the vast majority of model parameters did not materially affect model outcomes. Conclusion Over a 2‐year period, degludec improved clinical outcomes at a lower cost as compared to glargine U100 in patients with T2D at high risk of cardiovascular events and hypoglycaemia.

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“…This is supported by the insensitivity of the ICER to changes in the time horizon in the sensitivity analyses. The model has previously been used to evaluate the cost-effectiveness of degludec versus glargine U100 in patients with T1DM and T2DM in different settings [33,34,[38][39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria

Russel-Szymczyk

Valov

Savova

et al. 2019

Preprint

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Background This study investigates the cost-effectiveness of insulin degludec (degludec) versus biosimilar insulin glargine U100 (glargine U100) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in Bulgaria.Methods A simple, short-term model was used to compare the treatment costs and outcomes associated with hypoglycaemic events with degludec versus glargine U100 in patients with T1DM and T2DM from the perspective of the Bulgarian National Health Insurance Fund. Cost-effectiveness was analysed over a 1-year time horizon using data from clinical trials. The outcome measure was the incremental cost-effectiveness ratio (ICER).Results Degludec was highly cost-effective versus glargine U100 in people with T1DM and T2DM in Bulgaria. The ICERs were estimated to be 4,493.68 BGN/quality-adjusted life year (QALY) in T1DM, 399.11 BGN/QALY in T2DM on basal oral therapy (T2DM BOT ) and 7,365.22 BGN/QALY in T2DM on basal bolus therapy (T2DM B/B ), which all fall below the cost-effectiveness threshold of 39,619 BGN in Bulgaria. Insulin costs were higher with degludec in all three patient groups, however these were partially offset by savings from a reduction in hypoglycaemic events with degludec versus glargine U100. Sensitivity analysis demonstrated that the results were robust and largely insensitive to variations in input parameters. At a willingness-to-pay threshold of 39,619 BGN/QALY, the probability of degludec being cost-effective versus glargine U100 was 60.0% in T1DM, 99.4% in T2DM BOT and 91.3% in T2DM B/B .ConclusionDegludec is a cost-effective alternative to biosimilar glargine U100 for patients with T1DM and T2DM in Bulgaria. Degludec could be of particular benefit to those patients suffering recurrent hypoglycaemia and those who require additional flexibility in the dosing of insulin.

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A short-term cost-utility analysis of insulin degludec versus insulin glargine U100 in patients with type 1 or type 2 diabetes in Denmark

Abstract: Insulin degludec reduces incidence of hypoglycemia and improves quality-of-life in patients with diabetes. Over a 1-year time horizon, insulin degludec resulted in cost savings relative to insulin glargine in T1D and T2DBOT cohorts, while being cost-effective in T2DBB.

Cited by 16 publications

References 28 publications

ISPAD Clinical Practice Consensus Guidelines 2018: The delivery of ambulatory diabetes care to children and adolescents with diabetes

ISPAD Clinical Practice Consensus Guidelines 2018: The delivery of ambulatory diabetes care to children and adolescents with diabetes

Short‐term cost‐utility of degludec versus glargine U100 for patients with type 2 diabetes at high risk of hypoglycaemia and cardiovascular events: A Canadian setting (DEVOTE 9)

Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria

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