The clinical effectiveness and cost-effectiveness of inhaled insulin in diabetes mellitus: a systematic review and economic evaluation

Abstract

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Screening for cystic fibrosis-related diabetes: a systematic review.

“…Although the effects are not widely recognised, owing to any abnormalities being slight and subclinical, in a person with CF these changes could have a greater impact. 53 This is discussed in Chapter 2.…”

“…Black et al 53 reviewed evidence on the effects of diabetes on the lung for a Health Technology Assessment (HTA) review of inhaled insulin and noted: There is a loss of lung elasticity and recoil in diabetes and a greater rate of decline in lung function with age compared with non-diabetic subjects. As a result, the lungs become stiffer and harder to inflate and deflate.…”

Use of insulin in diabetes: a century of treatment

“…26 A systematic review showed that Exubera was not superior to short-acting insulin in other formats and was not cost-effective, so Pfizer discontinued production. 27 MannKind Corporation (Valencia [CA], US) received US FDA approval in June 2014 for its ultrarapid-acting inhalation human insulin powder, Afrezza, which contains recombinant human insulin using the technosphere concept and is administered via MannKind's next-generation inhaler called Dreamboat. Technosphere technology is based on the pH-induced intermolecular selfassembly of a novel small-molecule excipient (fumaryl diketopiperazine).…”

Managing diabetes with inhaled insulin

“…Hurdles that must be overcome in the continued development and launch of inhaled insulin products relate specifically to the cost/benefit ratio. The annual cost of inhaled insulin is estimated to be at least 2-4 fold higher than bioequivalent amounts of subcutaneous insulin depending on the population served [59]. Prescription benefit plans will need to determine whether cost savings that arise from improved patient adherence, including prevention of chronic diabetes complications, will justify the increased cost.…”