PMID- 38533582
OWN - NLM
STAT- MEDLINE
DCOM- 20240506
LR  - 20240506
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 40
IP  - 5
DP  - 2024 May
TI  - A short-term economic evaluation of early insulin therapy compared to oral 
      anti-diabetic drugs in order to reduce the major adverse events in type 2 
      diabetes patients in Iran.
PG  - 765-772
LID - 10.1080/03007995.2024.2333425 [doi]
AB  - OBJECTIVE: While there are some recommendations about early insulin therapy in 
      newly diagnosed Type 2 Diabetes Mellitus (T2DM) patients, there is not sufficient 
      evidence on this strategy's cost-effectiveness. This study compared early insulin 
      therapy versus oral anti-diabetic drugs (OADs) for managing T2DMusing a 
      cost-effectiveness analysis approach in Iran. METHODS: In this economic 
      evaluation, a decision analytic model was designed. The target population was 
      newly diagnosed type 2 diabetic patients, and the study was carried out from the 
      perspective of Iran's healthcare system with a one-year time horizon. Basal 
      insulin, Dipeptidyl peptidase-4 (DPP-4) inhibitors, and Thiazolidinediones (TZDs) 
      were compared in this evaluation. The main outcome for assessing the 
      effectiveness of each intervention was the reduction in the occurrence of 
      diabetes complications. Strategies were compared using the incremental 
      cost-effectiveness ratio (ICER), and deterministic and probabilistic sensitivity 
      analyses were carried out. RESULTS: The DPP-4 inhibitors strategy was the 
      dominant strategy with the highest effectiveness and the lowest cost. Early 
      insulin therapy was dominated (ICER: $-53,703.18), meaning that it was not 
      cost-effective. The sensitivity analyses consistently affirmed the robustness of 
      the base case findings. The probabilistic sensitivity analysis indicated 
      probabilities of 77%, 22%, and 1% for DPP-4 inhibitors, TZDs strategies, and 
      early insulin therapy, respectively, in terms of being cost-effective. 
      CONCLUSION: In terms of cost-effectiveness, early insulin therapy was not 
      cost-effective compared to OADs for managing newly diagnosed T2DM patients. 
      Future studies in this regard, utilizing more comprehensive evidence, can yield 
      more accurate results.
FAU - Heshmat, Ramin
AU  - Heshmat R
AD  - Chronic Diseases Research Center, Endocrinology and Metabolism Population 
      Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
FAU - Darvishi, Ali
AU  - Darvishi A
AD  - Chronic Diseases Research Center, Endocrinology and Metabolism Population 
      Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
FAU - Abdi Dezfouli, Ramin
AU  - Abdi Dezfouli R
AD  - Chronic Diseases Research Center, Endocrinology and Metabolism Population 
      Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
FAU - Nikkhah, Adeleh
AU  - Nikkhah A
AD  - Endocrinology and Metabolism Research Center, Endocrinology and Metabolism 
      Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
FAU - Radmanesh, Ramin
AU  - Radmanesh R
AD  - Department of Pharmacoeconomics and Pharmaceutical Management, Tehran Medical 
      Sciences, Islamic Azad University, Tehran, Iran.
FAU - Moslemi, Elham
AU  - Moslemi E
AD  - Department of Pharmacoeconomics and Pharmaceutical Management, Tehran Medical 
      Sciences, Islamic Azad University, Tehran, Iran.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20240402
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/drug therapy/economics
MH  - *Hypoglycemic Agents/economics/administration & dosage/therapeutic use/adverse 
      effects
MH  - *Insulin/administration & dosage/economics/therapeutic use/adverse effects
MH  - Iran
MH  - *Cost-Benefit Analysis
MH  - Administration, Oral
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - Dipeptidyl-Peptidase IV Inhibitors/economics/administration & dosage/therapeutic 
      use/adverse effects
OTO - NOTNLM
OT  - Cost-effectiveness
OT  - Early insulin therapy
OT  - Iran
OT  - Type 2 diabetes mellitus
OT  - oral anti-diabetic drugs
EDAT- 2024/03/27 06:43
MHDA- 2024/05/06 06:43
CRDT- 2024/03/27 04:23
PHST- 2024/05/06 06:43 [medline]
PHST- 2024/03/27 06:43 [pubmed]
PHST- 2024/03/27 04:23 [entrez]
AID - 10.1080/03007995.2024.2333425 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2024 May;40(5):765-772. doi: 10.1080/03007995.2024.2333425. 
      Epub 2024 Apr 2.