Cost-Effectiveness of iGlarLixi Versus Premix BIAsp 30 in Patients with Type 2 Diabetes Suboptimally Controlled by Basal Insulin in the UK

Abstract

Introduction iGlarLixi is indicated as an adjunct to diet and exercise in addition to metformin (with or without sodium-glucose cotransporter-2 inhibitors) to improve glycemic control in adults with insufficiently controlled type 2 diabetes (T2D). A cost-effectiveness analysis was conducted to compare iGlarLixi with premix biphasic insulin aspart 30 (BIAsp 30) in people with T2D suboptimally controlled with basal insulin (BI). Methods The IQVIA CORE Diabetes Model was used to estimate lifetime costs and outcomes for people with T2D from a UK health care perspective at a willingness-to-pay threshold of £20,000. Initial clinical data were based on the phase 3 randomized, open-label, active-controlled SoliMix clinical trial which compared the efficacy and safety of once-daily iGlarLixi with that of twice-daily BIAsp 30. Costs associated with management and complications and utilities values were derived from published sources. Lifetime costs (in £GBP) and quality-adjusted life-years (QALYs) were predicted; extensive scenario and sensitivity analyses were conducted. Results Estimated QALYs gained were slightly higher with iGlarLixi (8.9 vs. 8.8) compared with premix BIAsp 30, at a higher cost (£23,204 vs. £21,961). The base case incremental cost-effectiveness ratio (ICER) per QALY was £13,598. Treatment acquisition was the main driver of cost differences (iGlarLixi, £11,750; premix BIAsp 30, £10,395). Costs associated with management and complications were generally similar between comparators. Conclusion iGlarLixi provides improved QALY outcomes at an acceptable cost compared with premix BIAsp 30, with an ICER below the threshold generally considered acceptable by UK authorities. In people with T2D, iGlarLixi is a simple, cost-effective option for advancing therapy of BI, with fewer daily injections than premix BIAsp 30. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-022-01267-3.

Budget Impact Analysis of Intensification with iGlarLixi Compared to Alternative Treatment Strategies Among Patients with Type 2 Diabetes Mellitus

“…Similarly, a study in the UK showed that treatment acquisition was the main driver of cost differences between premix BIAsp 30 and iGlarLixi, making the latter a simple, cost-effective option for intensification [ 19 ]. Another study in the USA compared the healthcare resource utilization and costs for iGlarLixi with newly initiated free-dose combinations of basal insulin and GLP-1RA that were started either simultaneously or sequentially [ 18 ].…”

“…However, there have been few economic evaluations of iGlarLixi in patients with T2DM to date. Recent cost-effectiveness study reports from the USA [ 18 ] and UK [ 19 ] revealed that iGlarLixi confers improved quality adjusted life years (QALYs) and lower costs compared to premix biphasic insulin aspart 30 (BIAsp) in people with suboptimal glycemic control on basal insulin. Additionally, total estimated costs were lowest for iGlarLixi compared with other fixed- and free-dose combinations of insulins plus GLP-1RA [ 20 ].…”

Fixed-ratio combinations of basal insulin and glucagon-like peptide-1 receptor agonists as a promising strategy for treating diabetes

“…The same cost-saving effect was also confirmed in an IGlarLixi add-on strategy in people with T2D treated with oral antihyperglycemic agents[ 60 ]. IGlarLixi showed slightly higher estimated QALYs at an acceptable higher cost with a reduction in the daily injection frequency compared with twice daily BIAsp 30[ 61 ]. The cost-effectiveness of these two FRCs appears to be different.…”

How Functional Premix Feed Be Used for Improvement of the Reproductive Capacity of Cattle

“…(2) Promote metabolism. The premix feed is supplemented with vitamins and various microelements, which are essential active substances in the growth and metabolism of animals and active components of enzymes in the body [7], which are involved in the whole metabolic process of livestock and poultry growth, and thus the complete various life activities can be completed.…”