PMID- 23296753
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130621
LR  - 20211021
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 4
IP  - 1
DP  - 2013 Jun
TI  - Evaluation of insulin use and value for money in type 2 diabetes in the United 
      kingdom.
PG  - 51-66
LID - 10.1007/s13300-012-0018-3 [doi]
AB  - INTRODUCTION: It is unclear as to whether human or long-acting analog insulins 
      represent the most efficient use of health and non-healthcare resources in the 
      management of type 2 diabetes mellitus (T2DM). The aim of this study was to 
      evaluate the value for money relationship associated with the use of these 
      insulins in the UK setting. METHODS: A literature search was performed for 
      studies reporting expenditure associated with the use of human and analog 
      insulins. Data from this review informed a budget impact assessment model. Costs 
      were converted to a common currency and results are reported in 2011 British 
      pounds sterling (GBP) values. RESULTS: Annual diabetes-related medication 
      expenditure and patients total expenditure associated with the management of T2DM 
      were estimated to be  pound397 million and  pound3,901 million, respectively. Substitution 
      of human insulin for analog insulins was associated with a drug acquisition cost 
      saving of between  pound5 million and  pound23 million each year. Overall, though, total 
      expenditure increased significantly with increased use of human insulin by  pound34 
      million to  pound136 million each year depending on the degree of substitution. 
      CONCLUSIONS: On the face of it, analog insulins are more expensive, prompting 
      questions about potential cost savings to health services in the UK from direct 
      substitution to the less expensive human preparation. The current analysis 
      illustrates that the increased use of human insulin and decreased use of analog 
      insulin would, however, increase the overall net societal cost of managing 
      insulin-treated patients with T2DM. Governments and decision makers should 
      consider that total healthcare expenditure would not necessarily fall when 
      decisions are based solely on the use of cheaper products.
FAU - Gordon, Jason
AU  - Gordon J
AD  - Department of Public Health, University of Adelaide, Level 7, 178 North Terrace, 
      Adelaide, SA, 5005, Australia, jason.gordon@adelaide.edu.au.
FAU - Evans, Marc
AU  - Evans M
FAU - McEwan, Phil
AU  - McEwan P
FAU - Bain, Steve
AU  - Bain S
FAU - Vora, Jiten
AU  - Vora J
LA  - eng
PT  - Journal Article
DEP - 20130108
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC3687091
EDAT- 2013/01/09 06:00
MHDA- 2013/01/09 06:01
PMCR- 2013/01/08
CRDT- 2013/01/09 06:00
PHST- 2012/09/27 00:00 [received]
PHST- 2013/01/09 06:00 [entrez]
PHST- 2013/01/09 06:00 [pubmed]
PHST- 2013/01/09 06:01 [medline]
PHST- 2013/01/08 00:00 [pmc-release]
AID - 18 [pii]
AID - 10.1007/s13300-012-0018-3 [doi]
PST - ppublish
SO  - Diabetes Ther. 2013 Jun;4(1):51-66. doi: 10.1007/s13300-012-0018-3. Epub 2013 Jan 
      8.