Resource Consumption and Costs of Treatment in Patients with Type 1 Diabetes under Intensified Conventional Therapy under German Real-Life Conditions

Kostev, Karel; Dippel, FW; Bierwirth, R.

doi:10.1177/193229681300700319

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…Moreover, we utilized Taiwan's NHIRD, which is a data source with a nationwide representative population, for a comprehensive estimation of all economic consequences of treatments reimbursed by Taiwan's NHI for individuals with T1D. A cost analysis study of basal insulins for T1D in a real‐world setting was previously conducted using Germany's claims database, but a CEA was not performed and the cost estimates were based on only a 1‐year period. The study demonstrated a trend of lower annual costs for insulin glargine users owing to the lower costs of bolus insulin, blood glucose test strips, lancets, needles and antihypoglycaemic treatments vs NPH users.…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of long‐acting insulin analogues vs intermediate/long‐acting human insulin for type 1 diabetes: A population‐based cohort followed over 10 years

Lee

Kuo

Chen

et al. 2020

Brit J Clinical Pharma

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Aims: This study assessed the cost-effectiveness of long-acting insulin analogues (LAIAs) vs intermediate/long-acting human insulin (ILAHI) for patients with type 1 diabetes (T1D) in real-world clinical practice. Methods: Individual-level analyses were conducted within a longitudinal populationbased cohort of 540 propensity score-matched T1D patients (LAIAs, n = 270; ILAHI, n = 270) with over 10 years of follow-up using Taiwan's National Health Insurance Research Database, 2004-2013, from third-party payer and healthcare sector perspectives. The study outcomes included the number needed to treat (NNT) to prevent one case of clinical events (eg, hypoglycaemia, diabetes-related complications), medical costs, and cost per case of events prevented. Cost estimates are presented in 2013 British pounds (GBP, £). Results:The NNTs using LAIAs vs ILAHI to avoid one case of hypoglycaemia requiring medical assistance, outpatient hypoglycaemia and any diabetes-related complications were 12, 9 and 10 for mean follow-up periods of 5.84, 6.02 and 3.62 years, respectively. From third-party payer and healthcare sector perspectives, using LAIAs instead of ILAHI saved GBP6924-GBP7116 per case of hypoglycaemia requiring medical assistance prevented, GBP5346-GBP5508 per case of outpatient hypoglycaemia prevented, and GBP3570-GBP3680 per case of any diabetes-related complications prevented. Sensitivity analyses considering sampling uncertainty showed that using LAIAs over ILAHI yields at least a 76% probability of cost-saving for avoiding one case of hypoglycaemia requiring medical assistance, outpatient hypoglycaemia or any diabetes-related complications. Conclusions:This real-world evidence reveals that compared with ILAHI, the greater pharmaceutical costs associated with LAIAs for patients with T1D could be substantially offset by savings from averted hypoglycaemia or diabetes-related complications. K E Y W O R D Scost-effectiveness analysis, intermediate/long-acting human insulin, long-acting insulin analogues, longitudinal cohort study, type 1 diabetes Tsung-Ying Lee and Shihchen Kuo have equal first-authorship.

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Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of long‐acting insulin analogues vs intermediate/long‐acting human insulin for type 1 diabetes: A population‐based cohort followed over 10 years

Lee

Kuo

Chen

et al. 2020

Brit J Clinical Pharma

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“…However, there is plenty of evidence on this issue in the international literature [50]. For example, evidence has shown that compared with NPH, insulin analogues decreases the risk of severe hypoglycemia episodes by 38% (OR 0.62, 95% CI 0.42–0.91) [4], the risk of nocturnal hypoglycemia episodes by 46% (p = 0.04) [51], the risk of hospitalization due to the first severe hypoglycemic event by 21.7% (95% CI 9.6–32.1%,p<0.001) [52], the risk of hypoglycemic coma recurrence by 36.3% (95% CI 8.9–55.5%, p = 0.014) [52], hospitalizations by 49% [53], the incidence of macrovascular complications by 48% [54], and annual costs [55]. …”

Section: Discussionmentioning

confidence: 99%

Budget Impact of Long-Acting Insulin Analogues: The Case in Brazil

2016

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BackgroundLong-acting insulin analogues for type 1 diabetes (T1D) treatment have been available on the Brazilian market since 2002. However, the population cannot access the analogues through the public health system.ObjectiveTo estimate the incremental budget impact of long-acting insulin analogues coverage for T1D patients in the Brazilian public health system compared to NPH insulin.MethodsWe performed a budget impact analysis of a five-year period. The eligible population was projected using epidemiological data from the International Diabetes Federation estimates for patients between 0–14 and 20–79 years old. The prevalence of T1D was estimated in children, and the same proportion was applied to the 15-19-year-old group due to a gap in epidemiological information. We considered 4,944 new cases per year and a 34.61/100,000 inhabitants mortality rate. Market share for long-acting insulin analogues was assumed as 20% in the first year, reaching 40% in the fifth year. The mean daily dose was taken from clinical trials. We calculated the bargaining power of the Ministry of Health by dividing the price paid for human insulin in the last purchase by the average regulated price. We performed univariate and multivariate sensitivity analyses.ResultsThe incremental budget impact of long-acting insulin analogues was US$ 28.6 million in the first year, and reached US$ 58.7 million in the fifth year. The total incremental budget impact was US$ 217.9 million over the five-year period. The sensitivity analysis showed that the percentage of T1D among diabetic adults and the insulin analogue price were the main factors that affected the budget impact.ConclusionsThe cost of the first year of long-acting insulin analogue coverage would correspond to 0.03% of total public health expenditure. The main advantage of this study is that it identifies potential bargaining power because it features more realistic profiles of resource usage, once centralized purchasing is established as an economically sustainable strategy. Clinical guidelines restricting the use of insulin analogues would make the decision towards insulin analogue coverage more affordable.

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“…This study uses a retrospective data analysis of patients with gout using health-care data extracted from electronic medical record and administrative claims databases. The following databases were used: DE—IMS Disease Analyzer™ (IMS Health, Danbury, CT, US) databases [ 33 , 34 ]; UK—Clinical Practice Research Datalink (CPRD) Hospital Episode Statistics [ 18 , 35 ]; US—IMS PharMetrics Plus database [ 36 – 38 ]; FR—IMS Disease Analyzer database [ 39 , 40 ]. A more detailed description of these databases can be found in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

Comorbidity Burden in Trial-Aligned Patients with Established Gout in Germany, UK, US, and France: a Retrospective Analysis

Nyberg

Horne

Morlock³

et al. 2016

Adv Ther

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IntroductionPatients with gout have numerous comorbidities. We aimed to estimate the prevalence and incidence rates of renal and cardiovascular morbidities in trial-aligned patients with established gout in Germany (DE), the United Kingdom (UK), the United States (US), and France (FR).MethodsThis longitudinal cohort study used retrospective data from IMS Disease Analyzer™ (DE, FR), Clinical Practice Research Datalink–Hospital Episode Statistics (UK), and IMS’ PharMetrics Plus database linked with outpatient laboratory results (US). Included patients were ≥18 years at index date (January 1, 2010; all dates +1 year for FR), with continuous enrollment during the pre-index year, had “prevalent established gout” determined by data in the pre-index year, and ≥1 documented visit after index date; additional inclusion/exclusion criteria were aligned with recent gout clinical trials. Look-back for comorbidity prevalence extended to January 1, 2003 (US: January 1, 2009). Follow-up for incidence extended from index date to at most March 26, 2013 (FR: May 31, 2014). Events of interest were identified by diagnostic codes and/or laboratory data.ResultsThe trial-aligned cohorts included 35,118 (DE), 24,607 (UK), 121,591 (US), and 17,338 (FR) patients. Among renal conditions, baseline diagnosis of chronic kidney disease/renal failure was most prevalent in the UK followed by DE; abnormal serum creatinine was most prevalent in the UK. Hypertension was the most prevalent cardiovascular diagnosis in all countries, followed by ischemic heart disease (IHD) and myocardial infarction. Incidence rates (per 100 patient-years) for new/worsening renal impairment ranged from 1.67 (DE) to 4.34 (US) and for nephrolithiasis diagnosis from 0.31 (FR) to 3.79 (US). The incidence rates for hypertension diagnosis were highest among cardiovascular-related events, ranging from 3.23 (UK) to 20.27 (US), followed by IHD.ConclusionsPatients with established gout such as those included in gout trials have a high burden of established morbidity and new diagnoses of morbid events. Consideration of comorbidities, which greatly exacerbate disease burden, is important in gout management.FundingAstraZeneca.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-016-0346-1) contains supplementary material, which is available to authorized users.

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Resource Consumption and Costs of Treatment in Patients with Type 1 Diabetes under Intensified Conventional Therapy under German Real-Life Conditions

Abstract: Abbreviations: (ATC) anatomical therapeutic chemical, (BMI) body mass index, (CUA) cost-utility analysis, (HbA1c) hemoglobin A1c, (ICT) intensified conventional therapy, (NPH) neutral protamine Hagedorn, (QALY) quality-adjusted life year, (T1DM)

Cited by 6 publications

References 26 publications

Cost‐effectiveness of long‐acting insulin analogues vs intermediate/long‐acting human insulin for type 1 diabetes: A population‐based cohort followed over 10 years

Cost‐effectiveness of long‐acting insulin analogues vs intermediate/long‐acting human insulin for type 1 diabetes: A population‐based cohort followed over 10 years

Budget Impact of Long-Acting Insulin Analogues: The Case in Brazil

Comorbidity Burden in Trial-Aligned Patients with Established Gout in Germany, UK, US, and France: a Retrospective Analysis

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