PMID- 31482483
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201124
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 10
IP  - 5
DP  - 2019 Oct
TI  - Meta-Analysis and Cost-Effectiveness Analysis of Insulin Glargine 100 U/mL Versus 
      Insulin Degludec for the Treatment of Type 2 Diabetes in China.
PG  - 1969-1984
LID - 10.1007/s13300-019-00683-2 [doi]
AB  - INTRODUCTION: To evaluate the efficacy and safety as well as the long-term 
      cost-effectiveness of insulin glargine 100 U/mL (IGlar) versus insulin degludec 
      (IDeg) for the treatment of type 2 diabetes mellitus (T2DM) from the Chinese 
      healthcare system perspective. METHODS: A systematic search of English and 
      Chinese electronic databases for randomized controlled trials (RCTs) comparing 
      IGlar with IDeg for the treatment of T2DM was performed, followed by a 
      meta-analysis to compare the efficacy and safety of IGlar versus IDeg. The CORE 
      Diabetes Model was used to estimate lifetime costs, quality-adjusted life years 
      (QALYs) gained, and cost-effectiveness of IGlar versus IDeg. One-way and 
      probabilistic sensitivity analyses were conducted to assess the underlying 
      parameter uncertainty. RESULTS: Six RCTs were included in the meta-analysis. The 
      IGlar group showed a statistically significant decrease in glycated hemoglobin 
      (HbA(1c)) from baseline compared to the IDeg group (mean difference [MD] 0.08%, 
      95% confidence interval [CI] 0.01-0.14%, P = 0.02). Body mass index (BMI) control 
      was numerically better in the IGlar group than in the IDeg group (MD 
      0.07 kg/m(2), 95% CI - 0.01 to 0.14 kg/m(2), P  = 0.08). In terms of 
      hypoglycemia, the incidence of non-severe overall hypoglycemia was comparable 
      between the IDeg and IGlar patient groups (P  > 0.05), while the incidence of 
      non-severe nocturnal hypoglycemia (relative risk [RR 0.79], 95% CI 0.70-0.90, 
      P < 0.01) and the event rates of non-severe overall (RR 0.91, 95% CI 0.85-0.97, 
      P < 0.01) and non-severe nocturnal hypoglycemia (RR 0.91, 95% CI 0.85-0.97, 
      P < 0.01) were lower in the IDeg group. The incidences and event rates of both 
      severe overall and nocturnal hypoglycemia were similar for the two groups (P 
       > 0.05). The cost-effectiveness analysis showed that IGlar is the dominant 
      treatment option compared with IDeg, with a lifetime savings of 1004 Chinese yuan 
      in direct medical costs and a net gain of 0.015 QALYs per patient. Both one-way 
      and probabilistic sensitivity analyses confirmed the robustness of the results. 
      CONCLUSIONS: IGlar is a cost-saving option with incremental effectiveness 
      compared with IDeg for the treatment of T2DM in China. FUNDING: Sanofi China.
FAU - Su, Wen
AU  - Su W
AD  - Health Economics Research Institute, Sun Yat-sen University, Guangzhou, China.
FAU - Li, Chaoyun
AU  - Li C
AD  - Health Economics and Outcome Research, Sanofi, Shanghai, China.
FAU - Zhang, Lei
AU  - Zhang L
AD  - Shanghai Centennial Scientific, Shanghai, China.
FAU - Lin, Ziyi
AU  - Lin Z
AD  - Shanghai Centennial Scientific, Shanghai, China.
FAU - Tan, Jun
AU  - Tan J
AD  - Shanghai Centennial Scientific, Shanghai, China.
FAU - Xuan, Jianwei
AU  - Xuan J
AD  - Health Economics Research Institute, Sun Yat-sen University, Guangzhou, China. 
      xuanjw3@mail.sysu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20190903
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC6778565
OTO - NOTNLM
OT  - Cost-effectiveness
OT  - Insulin degludec
OT  - Insulin glargine
OT  - Meta-analysis
OT  - Type 2 diabetes
EDAT- 2019/09/05 06:00
MHDA- 2019/09/05 06:01
PMCR- 2019/10/01
CRDT- 2019/09/05 06:00
PHST- 2019/04/01 00:00 [received]
PHST- 2019/09/05 06:00 [pubmed]
PHST- 2019/09/05 06:01 [medline]
PHST- 2019/09/05 06:00 [entrez]
PHST- 2019/10/01 00:00 [pmc-release]
AID - 10.1007/s13300-019-00683-2 [pii]
AID - 683 [pii]
AID - 10.1007/s13300-019-00683-2 [doi]
PST - ppublish
SO  - Diabetes Ther. 2019 Oct;10(5):1969-1984. doi: 10.1007/s13300-019-00683-2. Epub 
      2019 Sep 3.