PMID- 27752998
OWN - NLM
STAT- MEDLINE
DCOM- 20171030
LR  - 20221207
IS  - 1179-2027 (Electronic)
IS  - 1170-7690 (Linking)
VI  - 35
IP  - 2
DP  - 2017 Feb
TI  - Systematic Review of the Cost Effectiveness of Insulin Analogues in Type 1 and 
      Type 2 Diabetes Mellitus.
PG  - 141-162
LID - 10.1007/s40273-016-0456-2 [doi]
AB  - BACKGROUND: Insulin analogues have a pharmacokinetic advantage over human insulin 
      and are increasingly used to treat diabetes mellitus. A summary of their cost 
      effectiveness versus other available treatments was required. OBJECTIVE: Our 
      objective was to systematically review the published cost-effectiveness studies 
      of insulin analogues for the treatment of patients with type 1 diabetes mellitus 
      (T1DM) and type 2 diabetes mellitus (T2DM). METHODS: We searched major databases 
      and health technology assessment agency reports for economic evaluation studies 
      published up until 30 September 2015. Two reviewers performed data extraction and 
      assessed the quality of the data using the CHEERS (Consolidated Health Economic 
      Evaluation Reporting Standards) guidelines. RESULTS: Seven of the included 
      studies assessed short-acting insulin analogues, 12 assessed biphasic insulin 
      analogues, 30 assessed long-acting insulin analogues and one assessed a 
      combination of short- and long-acting insulin analogues. Only 17 studies involved 
      patients with T1DM, all were modelling studies and 12 were conducted in Canada. 
      The incremental cost-effectiveness ratios (ICERs) for short-acting insulin 
      analogues ranged from dominant to $US435,913 per quality-adjusted life-year 
      (QALY) gained, the ICERs for biphasic insulin analogues ranged from dominant to 
      $US57,636 per QALY gained and the ICERs for long-acting insulin analogues ranged 
      from dominant to $US599,863 per QALY gained. A total of 15 studies met all the 
      CHEERS guidelines reporting quality criteria. Only 26 % of the studies assessed 
      heterogeneity in their analyses. CONCLUSION: Current evidence indicates that 
      insulin analogues are cost effective for T1DM; however, evidence for their use in 
      T2DM is not convincing. Additional evidence regarding compliance and efficacy is 
      required to support the broader use of long-acting and biphasic insulin analogues 
      in T2DM. The value of insulin analogues depends strongly on reductions in 
      hypoglycaemia event rates and its efficacy in lowering glycated haemoglobin 
      (HbA(1c)).
FAU - Shafie, Asrul Akmal
AU  - Shafie AA
AD  - Discipline of Social and Administrative Pharmacy, School of Pharmaceutical 
      Sciences, Universiti Sains Malaysia (USM), 11800, Penang, Malaysia. 
      aakmal@usm.my.
FAU - Ng, Chin Hui
AU  - Ng CH
AD  - Discipline of Social and Administrative Pharmacy, School of Pharmaceutical 
      Sciences, Universiti Sains Malaysia (USM), 11800, Penang, Malaysia.
FAU - Tan, Yui Ping
AU  - Tan YP
AD  - Discipline of Social and Administrative Pharmacy, School of Pharmaceutical 
      Sciences, Universiti Sains Malaysia (USM), 11800, Penang, Malaysia.
FAU - Chaiyakunapruk, Nathorn
AU  - Chaiyakunapruk N
AD  - School of Pharmacy, Monash University Malaysia, Selangor, Malaysia.
AD  - Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Center of 
      Pharmaceutical Outcomes Research (CPOR), Naresuan University, Phitsanulok, 
      Thailand.
AD  - School of Pharmacy, University of Wisconsin, Madison, WI, USA.
AD  - School of Population Health, University of Queensland, Brisbane, QLD, Australia.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulins)
MH  - Canada
MH  - Cost-Benefit Analysis
MH  - Delayed-Action Preparations
MH  - Diabetes Mellitus, Type 1/*drug therapy/economics
MH  - Diabetes Mellitus, Type 2/*drug therapy/economics
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage/economics
MH  - Insulins/*administration & dosage/economics
MH  - Quality-Adjusted Life Years
EDAT- 2016/10/19 06:00
MHDA- 2017/10/31 06:00
CRDT- 2016/10/19 06:00
PHST- 2016/10/19 06:00 [pubmed]
PHST- 2017/10/31 06:00 [medline]
PHST- 2016/10/19 06:00 [entrez]
AID - 10.1007/s40273-016-0456-2 [pii]
AID - 10.1007/s40273-016-0456-2 [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2017 Feb;35(2):141-162. doi: 10.1007/s40273-016-0456-2.