An analysis of the short- and long-term cost-effectiveness of starting biphasic insulin aspart 30 in insulin-naïve people with poorly controlled type 2 diabetes

Shafie, Asrul Akmal; Gupta, Vishal; Baabbad, Ranya; Hammerby, E.; Home, Philip

doi:10.1016/j.diabres.2014.08.024

Cited by 19 publications

(11 citation statements)

References 31 publications

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“…These results reinforce the value of initiating or optimizing treatment sooner rather than later in patients not reaching desired glycemic targets. Finally, new health-economic studies are also in line with previous work and now demonstrate that, projected over a 30-year horizon, BIAsp 30 is cost effective versus BHI 30, NPH insulin, or IGlar (in India, Saudi Arabia, and Indonesia) for both insulin-naïve [ 42 ] and insulin-experienced [ 43 ] patients.…”

Section: Discussionsupporting

confidence: 80%

“…The economic impact of switching from BHI 30, IGlar, or NPH insulin was projected over a 30-year horizon, and the impact on quality of life was projected over 1 year. BIAsp 30 was projected to be cost effective versus the other treatments over both the short (1 year) and long (30 years) term in insulin-naïve [ 42 ] and insulin-experienced patients [ 43 ].…”

Section: Cost Effectivenessmentioning

confidence: 99%

“…BIAsp 30 was projected to be cost effective versus the other treatments over both the short (1 year) and long (30 years) term in insulin-naïve [ 42 ] and insulin-experienced patients [ 43 ].…”

Section: Cost Effectivenessmentioning

confidence: 99%

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15 Years of Experience with Biphasic Insulin Aspart 30 in Type 2 Diabetes

et al. 2018

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Since clinical experience with biphasic insulin aspart 30 (BIAsp 30) in type 2 diabetes mellitus (T2DM) was reviewed in 2012 after 10 years of use worldwide, additional studies have been published that highlight new aspects, including use in real-world populations. Evidence from 35 new studies confirms and builds upon previous work indicating that BIAsp 30 continues to have pharmacodynamic and clinical advantages over biphasic human insulin (BHI 30), including in real-world practice with unselected populations of patients. BIAsp 30 has also been shown to be safe and efficacious as an add-on to dipeptidyl peptidase-4 (DPP-4) inhibitors. Intensification with BIAsp 30 is a safe and effective way to improve glycemic control, and titration performed by patients can achieve results that are at least comparable to those when being guided by healthcare providers. Stepwise intensification using BIAsp 30 is comparable to intensification using a basal–bolus regimen, and twice-daily BIAsp 30 provides similar glycemic control to a basal-plus regimen. Data from large observational studies, in particular, have identified patient-related characteristics that are associated with improved clinical responses, suggesting that earlier initiation and intensification of therapy is warranted. Finally, new health-economic analyses continue to confirm that BIAsp 30 is cost effective versus other therapies such as BHI 30, neutral protamine Hagedorn (NPH), or insulin glargine in both insulin-naïve and insulin-experienced patients. After 15 years of clinical use worldwide, analysis of more recent 5-year data indicates that BIAsp 30 remains a safe, effective, and simple-to-use insulin for initiation and intensification by diabetes specialists and primary care physicians in a variety of patients with T2DM.

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Section: Discussionsupporting

confidence: 80%

Section: Cost Effectivenessmentioning

confidence: 99%

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15 Years of Experience with Biphasic Insulin Aspart 30 in Type 2 Diabetes

et al. 2018

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“…These two instruments have been proved valid in many contexts, and across many health conditions in many countries [ 6 , 8 – 16 ], including Indonesia [ 17 , 18 ]. In Indonesia, both questionnaires are increasingly being used in different types of investigations, for example in the measurement of quality of life in different patient groups [ 19 – 22 ] and in cost-effectiveness studies [ 23 – 25 ]. Thus far, no investigation has measured the stability over time of both questionnaires when measuring the HRQOL of the Indonesian general population: the test-retest reliability.…”

Section: Introductionmentioning

confidence: 99%

Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF

et al. 2018

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ObjectivesThe objective of this study is to obtain population norms and to assess test-retest reliability of EQ-5D-5L and WHOQOL-BREF for the Indonesian population.MethodsA representative sample of 1056 people aged 17–75 years was recruited from the Indonesian general population. We used a multistage stratified quota sampling method with respect to residence, gender, age, education level, religion and ethnicity. Respondents completed EQ-5D-5L and WHOQOL-BREF with help from an interviewer. Norms data for both instruments were reported. For the test-retest evaluations, a sub-sample of 206 respondents completed both instruments twice.ResultsThe total sample and test-retest sub-sample were representative of the Indonesian general population. The EQ-5D-5L shows almost perfect agreement between the two tests (Gwet’s AC: 0.85–0.99 and percentage agreement: 90–99%) regarding the five dimensions. However, the agreement of EQ-VAS and index scores can be considered as poor (ICC: 0.45 and 0.37 respectively). For the WHOQOL-BREF, ICCs of the four domains were between 0.70 and 0.79, which indicates moderate to good agreement. For EQ-5D-5L, it was shown that female and older respondents had lower EQ-index scores, whilst rural, younger and higher-educated respondents had higher EQ-VAS scores. For WHOQOL-BREF: male, younger, higher-educated, high-income respondents had the highest scores in most of the domains, overall quality of life, and health satisfaction.ConclusionsThis study provides representative estimates of self-reported health status and quality of life for the general Indonesian population as assessed by the EQ-5D-5L and WHOQOL-BREF instruments. The descriptive system of the EQ-5D-5L and the WHOQOL-BREF have high test-retest reliability while the EQ-VAS and the index score of EQ-5D-5L show poor agreement between the two tests. Our results can be useful to researchers and clinicians who can compare their findings with respect to these concepts with those of the Indonesian general population.

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“…The ratio values used for different discount rates to calculate undiscounted outcomes for the rest of the 31 studies (59/124 data points) can be found in Supplementary Material 4. One study [ 33 ] with four comparators was excluded from the QALYs regression analysis because it involved a large utility change in year 1 (0.152–0.312) as a direct treatment effect stemming from the intervention. This makes the relationship between HbA 1c and QALY gain in this study not comparable to others, as other studies generally assumed changes in utility were mediated through changes in other risk factors such as BMI.…”

Section: Resultsmentioning

confidence: 99%

How Consistent is the Relationship between Improved Glucose Control and Modelled Health Outcomes for People with Type 2 Diabetes Mellitus? a Systematic Review

et al. 2016

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BackgroundThere are an increasing number of studies using simulation models to conduct cost-effectiveness analyses for type 2 diabetes mellitus.ObjectiveTo evaluate the relationship between improvements in glycosylated haemoglobin (HbA1c) and simulated health outcomes in type 2 diabetes cost-effectiveness studies.MethodsA systematic review was conducted on MEDLINE and EMBASE to collect cost-effectiveness studies using type 2 diabetes simulation models that reported modelled health outcomes of blood glucose-related interventions in terms of quality-adjusted life-years (QALYs) or life expectancy (LE). The data extracted included information used to characterise the study cohort, the intervention’s treatment effects on risk factors and model outcomes. Linear regressions were used to test the relationship between the difference in HbA1c (∆HbA1c) and incremental QALYs (∆QALYs) or LE (∆LE) of intervention and control groups. The ratio between the ∆QALYs and ∆LE was calculated and a scatterplot between the ratio and ∆HbA1c was used to explore the relationship between these two.ResultsSeventy-six studies were included in this research, contributing to 124 pair of comparators. The pooled regressions indicated that the marginal effect of a 1% HbA1c decrease in intervention resulted in an increase in life-time QALYs and LE of 0.371 (95% confidence interval 0.286–0.456) and 0.642 (95% CI 0.494–0.790), respectively. No evidence of heterogeneity between models was found. An inverse exponential relationship was found and fitted between the ratio (∆QALY/∆LE) and ∆HbA1c.ConclusionThere is a consistent relationship between ∆HbA1c and ∆QALYs or ∆LE in cost-effectiveness analyses using type 2 diabetes simulation models. This relationship can be used as a diagnostic tool for decision makers.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-016-0466-0) contains supplementary material, which is available to authorized users.

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An analysis of the short- and long-term cost-effectiveness of starting biphasic insulin aspart 30 in insulin-naïve people with poorly controlled type 2 diabetes

Abstract: Starting BIAsp 30 in people with type 2 diabetes in the A(1)chieve study was found to be cost-effective across all country settings at 1- and 30-year time horizons, and usefully increased predicted life expectancy.

Cited by 19 publications

References 31 publications

15 Years of Experience with Biphasic Insulin Aspart 30 in Type 2 Diabetes

15 Years of Experience with Biphasic Insulin Aspart 30 in Type 2 Diabetes

Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF

How Consistent is the Relationship between Improved Glucose Control and Modelled Health Outcomes for People with Type 2 Diabetes Mellitus? a Systematic Review

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