PMID- 24373113
OWN - NLM
STAT- MEDLINE
DCOM- 20141204
LR  - 20161125
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Linking)
VI  - 16
IP  - 4
DP  - 2014 Apr
TI  - Cost-effectiveness of insulin degludec compared with insulin glargine for 
      patients with type 2 diabetes treated with basal insulin - from the UK health 
      care cost perspective.
PG  - 366-75
LID - 10.1111/dom.12250 [doi]
AB  - AIMS: The aim of this analysis was to evaluate the cost-effectiveness of insulin 
      degludec (IDeg) versus insulin glargine (IGlar) in adults with type 2 diabetes 
      mellitus (T2DM) who are considered appropriate for treatment with a basal insulin 
      analogue, using a short-term economic model. METHODS: Meta-analysis data from 
      three phase III clinical studies were used to populate a simple and transparent 
      short-term model. The costs and effects of treatment with IDeg versus IGlar were 
      calculated over a 12-month period. The analysis was conducted from the 
      perspective of the UK National Health Service. Sensitivity analyses were 
      conducted to assess the degree of uncertainty surrounding the results. RESULTS: 
      IDeg is a cost-effective treatment option versus IGlar in patients with T2DM 
      using basal insulin. Base case incremental cost-effectiveness ratios (ICERs) were 
      estimated at  pound15,795 per quality-adjusted life-year (QALY) and  pound13,078 per QALY, 
      which are below commonly accepted thresholds for cost-effectiveness. Sensitivity 
      analyses demonstrated that hypoglycaemia event rates had an important effect on 
      the results. With higher event rates for non-severe hypoglycaemia IDeg was less 
      costly and more effective than IGlar (dominant). Conversely, using lower event 
      rates for severe hypoglycaemia generated higher ICERs. Using hypoglycaemia rates 
      from a subgroup of patients who experienced >/=1 hypoglycaemic event per year IDeg 
      was highly cost-effective versus IGlar; with estimated ICERS of  pound4887 and  pound2625 
      per QALY. CONCLUSIONS: This short-term modelling approach allows the economic 
      evaluation of newer insulin analogues when advanced long-term modelling based on 
      HbA1c differences is inappropriate. For patients with T2DM who are considered 
      appropriate for treatment with a basal insulin analogue, IDeg is a cost-effective 
      treatment option compared with IGlar and offers additional benefits to subgroups 
      of patients, such as those suffering from recurrent hypoglycaemia.
CI  - (c) 2014 John Wiley & Sons Ltd.
FAU - Evans, M
AU  - Evans M
AD  - University Hospital Llandough, Cardiff, UK.
FAU - Wolden, M
AU  - Wolden M
FAU - Gundgaard, J
AU  - Gundgaard J
FAU - Chubb, B
AU  - Chubb B
FAU - Christensen, T
AU  - Christensen T
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20140116
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Insulin, Long-Acting)
RN  - 2ZM8CX04RZ (Insulin Glargine)
RN  - 54Q18076QB (insulin degludec)
SB  - IM
CIN - Diabetes Obes Metab. 2014 Apr;16(4):289-93. PMID: 24460874
MH  - Adult
MH  - Clinical Trials, Phase III as Topic
MH  - Cost-Benefit Analysis
MH  - Diabetes Mellitus, Type 2/*drug therapy/*economics
MH  - Drug Administration Schedule
MH  - Female
MH  - Health Care Costs
MH  - Humans
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/administration & dosage/adverse effects/*economics
MH  - Insulin/*analogs & derivatives
MH  - Insulin Glargine
MH  - Insulin, Long-Acting/administration & dosage/adverse effects/*economics
MH  - Male
MH  - Models, Economic
MH  - National Health Programs/economics
MH  - Quality-Adjusted Life Years
MH  - Treatment Outcome
MH  - United Kingdom
OTO - NOTNLM
OT  - cost-effectiveness
OT  - insulin analogues
OT  - insulin therapy
OT  - pharmaco-economics
OT  - type 2 diabetes
EDAT- 2014/01/01 06:00
MHDA- 2014/12/15 06:00
CRDT- 2013/12/31 06:00
PHST- 2013/07/05 00:00 [received]
PHST- 2013/08/27 00:00 [revised]
PHST- 2013/12/12 00:00 [accepted]
PHST- 2013/12/31 06:00 [entrez]
PHST- 2014/01/01 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - 10.1111/dom.12250 [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2014 Apr;16(4):366-75. doi: 10.1111/dom.12250. Epub 2014 Jan 
      16.