Cost-Effectiveness of Switching Patients with Type 2 Diabetes from Insulin Glargine to Insulin Detemir in Chinese Setting: A Health Economic Model Based on the PREDICTIVE Study

Yang, Li; Christensen, Torsten; Sun, Fengyu; Chang, J.Y.

doi:10.1016/j.jval.2011.11.018

Cited by 22 publications

(9 citation statements)

References 12 publications

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“…The improvements in glycemic control observed in the current study conflict with results from the PREDICTIVE trial [13, 14] but are consistent with those from two US studies [15, 16]. In our study, the treatment persistence rate was significantly higher in the GLA-C group and medication adherence was significantly higher among GLA-S patients.…”

Section: Discussionsupporting

confidence: 89%

“…In a European cohort of patients ( n = 777) in the PREDICTIVE study, there were significant improvements in HbA 1c with fewer hypoglycemic events after switching to insulin detemir [13]. Using the framework of cost-effectiveness analysis, an Asian study based on data from a Korean cohort of the PREDICTIVE study reported reduced total diabetes care costs and increased life expectancy of 0.06 years after switching from insulin glargine to insulin detemir [14]. A small retrospective study recently evaluated outcomes in patients ( n = 10 with type 1 diabetes and n = 21 with T2DM) switching from insulin glargine to insulin detemir due to changes in Medicaid formulary coverage [15].…”

Section: Introductionmentioning

confidence: 99%

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Much Ado About Nothing? A Real-World Study of Patients with Type 2 Diabetes Switching Basal Insulin Analogs

et al. 2014

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IntroductionType-2 diabetes mellitus (T2DM) is a progressive disease, and many patients eventually require insulin therapy. This study examined real-world outcomes of switching basal insulin analogs among patients with T2DM.MethodsUsing two large United States administrative claims databases (IMPACT® and Humana®), this longitudinal retrospective study examined two cohorts of adult patients with T2DM. Previously on insulin glargine, Cohort 1 either continued insulin glargine (GLA-C) or switched to insulin detemir (DET-S), while Cohort 2 was previously on insulin detemir, and either continued insulin detemir (DET-C) or switched to insulin glargine (GLA-S). One-year follow-up treatment persistence and adherence, glycated hemoglobin (HbA1c), hypoglycemia events, healthcare utilization and costs were assessed. Selection bias was minimized by propensity score matching between treatment groups within each cohort.ResultsA total of 5,921 patients (mean age 60 years, female 50.0%, HbA1c 8.6%) were included in the analysis (Cohort 1: IMPACT®: n = 536 DET-S matched to n = 2,668 GLA-C; Humana®: n = 256 DET-S matched to n = 1,262 GLA-C; Cohort 2: n = 419 GLA-S matched to n = 780 DET-C), with similar baseline characteristics between treatment groups in each cohort. During 1-year follow-up, in Cohort 1, DET-S patients, when compared with GLA-C patients, had lower treatment persistence/adherence with 33–40% restarting insulin glargine, higher rapid-acting insulin use, worse HbA1c outcomes, significantly higher diabetes drug costs, and similar hypoglycemia rates, health care utilization and total costs. However, in Cohort 2 overall opposite outcomes were observed and only 19.8% GLA-S patients restarted insulin detemir.ConclusionsThis study showed contrasting clinical and economic outcomes when patients with T2DM switched basal insulin analogs, with worse outcomes observed for patients switching from insulin glargine to insulin detemir and improved outcomes when switching from insulin detemir to insulin glargine. Further investigation into the therapeutic interchangeability of insulin glargine and insulin detemir in the real-world setting is needed.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-014-0120-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Much Ado About Nothing? A Real-World Study of Patients with Type 2 Diabetes Switching Basal Insulin Analogs

et al. 2014

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“…A key advantage of the present analysis is the simplicity and transparency of the model used to evaluate cost-utility. The majority of published cost-utility analyses of both type 1 and type 2 diabetes interventions have taken a long-term perspective, evaluating clinical and cost outcomes over patient lifetimes [32][33][34][35] . A long-term modeling approach is consistent with the progression of diabetes, with diabetesrelated complications in the future having a significant impact on quality-of-life and medical costs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the cost-utility of insulin degludec vs insulin glargine in Sweden

Ericsson

Pollock²,

Hunt³

et al. 2013

Journal of Medical Economics

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“…Detailed calculation methods are presented in Appendix S5 and Appendix S6. The cost data missed in the CHIRA database were derived from other Chinese literature …”

Section: Methodsmentioning

confidence: 99%

Comparison of lixisenatide in combination with basal insulin vs other insulin regimens for the treatment of patients with type 2 diabetes inadequately controlled by basal insulin: Systematic review, network meta‐analysis and cost‐effectiveness analysis

Men

Qu²,

Luo³

et al. 2019

Diabetes Obesity Metabolism

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Aims To evaluate the comparative efficacy and safety of lixisenatide combined with basal insulin (BI) vs intensive premix insulin (premix), BI plus prandial insulin with the main meal (basal‐plus) or progressively covering all meals (basal‐bolus) in patients with type 2 diabetes mellitus (T2DM) inadequately controlled by BI, and the long‐term cost‐effectiveness of lixisenatide from a Chinese healthcare system perspective. Materials and methods Randomized controlled trials (RCTs) published between 1998 and 2018 were systematically searched. The clinical efficacy and safety of each treatment were compared by network meta‐analysis (NMA). The IQVIA CORE Diabetes Model was used to estimate the lifetime quality‐adjusted life‐years (QALYs) and direct medical costs of patients treated with different strategies. Results Eight RCTs were finally included. Lixisenatide plus BI showed a similar reduction in HbA1c from baseline compared with premix, basal‐plus and basal‐bolus. There were significant differences in the change of body weight in favour of lixisenatide plus BI compared with the three insulin regimens. The risk of symptomatic hypoglycaemia of lixisenatide plus BI was significantly lower compared with premix and basal‐bolus. Lixisenatide plus BI was cost‐effective compared with premix, basal‐plus and basal‐bolus with incremental cost‐effectiveness ratios of Chinese yuan (CNY) 87 219, 48 173 and 48 670 per QALY gained, respectively, under the threshold of three times the gross domestic product (GDP) per capita in China. Conclusions Lixisenatide plus BI shows a similar HbA1c reduction compared with insulin regimens, accompanied by lower risk of hypoglycaemia and greater body weight reduction. It is a cost‐effective treatment alternative for patients with T2DM inadequately controlled by BI in China.

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Cost-Effectiveness of Switching Patients with Type 2 Diabetes from Insulin Glargine to Insulin Detemir in Chinese Setting: A Health Economic Model Based on the PREDICTIVE Study

Abstract: Conversion to IDet from an IGla regimen improved life expectancy and was a cost-saving treatment approach in a Chinese setting.

Cited by 22 publications

References 12 publications

Much Ado About Nothing? A Real-World Study of Patients with Type 2 Diabetes Switching Basal Insulin Analogs

Much Ado About Nothing? A Real-World Study of Patients with Type 2 Diabetes Switching Basal Insulin Analogs

Evaluation of the cost-utility of insulin degludec vs insulin glargine in Sweden

Comparison of lixisenatide in combination with basal insulin vs other insulin regimens for the treatment of patients with type 2 diabetes inadequately controlled by basal insulin: Systematic review, network meta‐analysis and cost‐effectiveness analysis

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