Title |
Cost-Effectiveness of Insulin Degludec vs. Insulin Glargine U100 in Type 1 and Type 2 Diabetes Mellitus in a UK Setting
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Published in |
Diabetes Therapy, August 2018
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DOI | 10.1007/s13300-018-0478-1 |
Pubmed ID | |
Authors |
Marc Evans, Roopa Mehta, Jens Gundgaard, Barrie Chubb |
Abstract |
Understanding which therapeutic innovations in diabetes represent the best value requires rigorous economic evaluation. Data from randomised controlled trials and observational studies indicate that insulin degludec has a hypoglycemia advantage versus insulin glargine 100 units/mL (glargine U100), the most widely prescribed basal insulin analogue in the UK. This analysis was done to more rigorously assess cost-effectiveness in a UK setting. Data from two double-blinded, randomised, two-period crossover trials in type 1 (SWITCH 1) and type 2 (SWITCH 2) diabetes mellitus were used to assess the cost-effectiveness of degludec vs. glargine U100 with an economic model. Cost-effectiveness was analysed over a 1-year time horizon based on the different rates of hypoglycaemia and actual doses of insulin used, rather than glycaemic control due to the treat-to-target trial design. In type 1 diabetes mellitus, degludec was highly cost-effective compared with glargine U100, with an incremental cost-effectiveness ratio of £984 (increased costs of only £23/year and improvement in participant health of 0.0232 quality-adjusted life-years (QALYs)). In type 2 diabetes mellitus, it was estimated that quality of life was improved (0.0065 QALYs gain) with degludec compared with glargine U100 at an increased annual cost of £117 (incremental cost-effectiveness ratio, £17,939). One-way sensitivity analyses showed that the results were robust to changes in parameters in both type 1 and type 2 diabetes mellitus. The rigorous design of the SWITCH trials, coupled with a representative patient population and a definition of hypoglycaemia that is relevant for real-world patients, makes the results of these trials highly generalisable. The within-trial analysis has the added value of being able to include doses and event rates directly from the trials. This short-term economic analysis estimated that IDeg would be cost-effective relative to IGlar U100 in both type 1 and type 2 diabetes mellitus in the UK. SWITCH 1 (NCT02034513); SWITCH 2 (NCT02030600). Novo Nordisk, Søborg, Denmark. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 46 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 7 | 15% |
Student > Ph. D. Student | 4 | 9% |
Student > Postgraduate | 3 | 7% |
Student > Bachelor | 3 | 7% |
Other | 2 | 4% |
Other | 7 | 15% |
Unknown | 20 | 43% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 10 | 22% |
Psychology | 3 | 7% |
Nursing and Health Professions | 3 | 7% |
Agricultural and Biological Sciences | 2 | 4% |
Biochemistry, Genetics and Molecular Biology | 2 | 4% |
Other | 5 | 11% |
Unknown | 21 | 46% |