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

Ericsson, Åsa; Pollock, Richard F; Hunt, Barnaby; Valentine, William J.

doi:10.3111/13696998.2013.852099

Cited by 27 publications

(38 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Cardiovascular Safetymentioning

confidence: 99%

“…In total, 80 patients in 16 [66]. While pharmacy costs for IDeg were higher, these were partially offset by cost savings due to reduced insulin doses, reduced direct costs of hypoglycaemia, reduced productivity losses and reduced costs of blood glucose monitoring [66]. Depending on the diabetic population (T1DM, T2DM basal-only insulin or T2DM basal-bolus insulin), IDeg was associated with incremental cost-effectiveness ratios of SEK 19,766, SEK 10, 082 and SEK 36, 074, respectively, per QALY gained [66].…”

Section: Cardiovascular Safetymentioning

confidence: 99%

See 1 more Smart Citation

Clinical use of insulin degludec

Vora

Cariou

Evans

et al. 2015

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

The limitations of current basal insulin preparations include concerns related to their pharmacokinetic and pharmacodynamic properties, hypoglycaemia, weight gain, and perception of management complexity, including rigid dosing schedules. Insulin degludec (IDeg) is a novel basal insulin with improved pharmacokinetic and pharmacodynamic properties compared to insulin glargine (IGlar) including a long half-life of ∼25 h and a duration of action >42 h at steady state, providing a flat and stable blood glucose-lowering effect when injected once daily. Evidence from phase 3a clinical trials with a treat-to-target design in patients with type 1 and type 2 diabetes has shown that IDeg has similar efficacy to IGlar, with a 9% and 26% reduction in risk of overall and nocturnal hypoglycaemia, respectively (in the pooled population) during the entire treatment period, and a 16% and 32% reduction during the maintenance period, respectively. Given its pharmacodynamic properties, IDeg offers a broad dosing window, allowing for flexible dose administration, if required. Two different formulations of IDeg are available (100 units/mL [U100] and 200 units/mL), the latter providing the same IDeg dose as the U100 formulation in half the injection volume. The unique pharmacokinetic profile of IDeg facilitates glycaemic control while minimising the risk of nocturnal hypoglycaemia.

show abstract

Section: Cardiovascular Safetymentioning

confidence: 99%

Section: Cardiovascular Safetymentioning

confidence: 99%

Clinical use of insulin degludec

Vora

Cariou

Evans

et al. 2015

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

show abstract

“…A cost-utility model based on both data from a meta-analysis of phase 3 trials and a questionnaire-based study conducted in Sweden, reported that IDeg was associated with greater quality adjusted life year (QALY) gains in patients with T1DM (0.31 vs 0.26 QALYs gained for IGlar), patients with T2DM requiring basal insulin (0.76 vs 0.69 QALYs gained) and patients with T2DM requiring basal-bolus treatment (0.56 vs 0.47 QALYs gained) after one year of treatment. 26 While pharmacy costs for IDeg were higher, these were partially offset by cost savings due to reduced insulin doses, reduced direct costs of hypoglycemia, reduced productivity losses and reduced costs of blood glucose monitoring. 26 Similarly, two UK-based studies examined cost-utility of IDeg compared to IGlar in the context of the UK national health service, in patients with T1DM and T2DM, using hypoglycemia rates for IDeg and IGlar from a pre-planned metaanalysis of phase III clinical trials.…”

Section: Efficacy and Safety Of Insulin Degludec In Subjects With Diamentioning

confidence: 99%

“…26 While pharmacy costs for IDeg were higher, these were partially offset by cost savings due to reduced insulin doses, reduced direct costs of hypoglycemia, reduced productivity losses and reduced costs of blood glucose monitoring. 26 Similarly, two UK-based studies examined cost-utility of IDeg compared to IGlar in the context of the UK national health service, in patients with T1DM and T2DM, using hypoglycemia rates for IDeg and IGlar from a pre-planned metaanalysis of phase III clinical trials. In both studies, IDeg was within the previously reported willingnessto-pay threshold of £20,000 to £30,000 per QALY.…”

Section: Efficacy and Safety Of Insulin Degludec In Subjects With Diamentioning

confidence: 99%

Inpatient hyperglycemia management: the opportunities of a new basal insulin

Simioni¹

2016

Ital J Med

View full text Add to dashboard Cite

The management of hospitalized diabetic patients for any cause is often difficult and affected not only by the comorbidities of the patient but also by the hospital setting. It is well known that at the admission the antidiabetic drugs should be discontinued on behalf of insulin therapy with insulin analogues, as a function of a basal-bolus insulin approach according to the phenotype of the patient, type of nutrition (enteral or parenteral rather than oral), or concomitant hyperglycemic therapy (e.g., steroid). The average stay of diabetic patients hospitalized for any cause is significantly correlated with both the number of hypoglycemia and hyperglycemia. Compared to patients treated with sliding scale patients using a custom algorithm show a significant reduction in the number of hypoglycemia and hyperglycemia episodes and in the length of stay. We analyze the clinical profile of a novel basal insulin, degludec, and explore the potential clinical benefit for diabetic inpatient. The continuation of insulin therapy at home in the immediate post-hospitalization (if necessary), also correlates with a reduction in the rate of re-hospitalization, which combined with close follow-up diabetes can result in a reduction of chronic complications.

show abstract

“…It follows that there are no differences in long-term risk parameters related to HbA 1c , and a short-term cost-effectiveness model is more appropriate for an economic evaluation of these secondary end points than a long-term model. Such a model has been used to compare treatment with IDeg versus insulin glargine in patients with type 1 diabetes mellitus (T1DM) and T2DM, from Swedish and UK health-care perspectives [12–14]. …”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Insulin Degludec/Insulin Aspart Versus Biphasic Insulin Aspart in Patients with Type 2 Diabetes from a Danish Health-Care Perspective

2016

View full text Add to dashboard Cite

IntroductionTo evaluate the cost-effectiveness of the co-formulation insulin degludec/insulin aspart (IDegAsp) versus biphasic insulin aspart (BIAsp 30), both administered twice daily, in patients with type 2 diabetes mellitus (T2DM), using a short-term cost-effectiveness model.MethodsData from two phase 3a treat-to-target clinical trials were used to populate a simple and transparent short-term cost-effectiveness model. The costs and effects of treatment with IDegAsp versus BIAsp 30 were calculated over a 5-year period, from a Danish health-care cost perspective. One-way and probabilistic sensitivity analyses were conducted to assess the degree of uncertainty and robustness of the results.ResultsThe base-case incremental cost-effectiveness ratio (ICER) of 81,507.91 Danish Kroner (DKK) per quality-adjusted life year (QALY) demonstrates that IDegAsp is a cost-effective treatment compared with BIAsp 30, over a 5-year time horizon. One-way sensitivity analyses show that the ICERs remain within an acceptable range when the rates of hypoglycemia, unit cost of hypoglycemia, disutilities of hypoglycemic events, and the time horizon are varied, ranging from 71,012 DKK to 209,446 DKK. The probabilistic sensitivity analysis demonstrates that the probability that IDegAsp is cost-effective relative to BIAsp 30 is 99.50%, assuming a cost-effectiveness threshold of 250,000 DKK per QALY.ConclusionThis short-term cost-effectiveness model shows that IDegAsp is a cost-effective treatment compared with BIAsp 30 for patients with T2DM. This result is primarily driven by significant reductions in severe hypoglycemia and insulin dose observed with IDegAsp versus BIAsp 30. Sensitivity analyses demonstrate the robustness of these results.FundingNovo Nordisk A/S, Søborg, Denmark.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-016-0195-6) contains supplementary material, which is available to authorized users.

show abstract

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

Abstract: Based on reduced incidence of hypoglycemia and possibility for flexibility around timing of dose administration, use of degludec is likely to be cost-effective compared to glargine from a societal perspective in T1D, T2-BOT, and T2-BB in Sweden over a 1-year time horizon.

Cited by 27 publications

References 27 publications

Clinical use of insulin degludec

Clinical use of insulin degludec

Inpatient hyperglycemia management: the opportunities of a new basal insulin

Cost-Effectiveness of Insulin Degludec/Insulin Aspart Versus Biphasic Insulin Aspart in Patients with Type 2 Diabetes from a Danish Health-Care Perspective

Contact Info

Product

Resources

About