Cost-Effectiveness of Insulin Degludec Versus Insulin Glargine U300 in the Netherlands: Evidence From a Randomised Controlled Trial.

Autor: Evans M; University Hospital Llandough, Penarth, UK. marclyndon1@hotmail.com., Moes RGJ; Novo Nordisk B.V., Alphen aan den Rijn, Netherlands., Pedersen KS; Novo Nordisk Region Europe, Copenhagen, Denmark., Gundgaard J; Novo Nordisk A/S, Søborg, Denmark., Pieber TR; Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Jazyk: angličtina
Zdroj: Advances in therapy [Adv Ther] 2020 May; Vol. 37 (5), pp. 2413-2426. Date of Electronic Publication: 2020 Apr 18.
DOI: 10.1007/s12325-020-01332-y
Abstrakt: Introduction: This study aimed to evaluate the short-term cost-effectiveness of insulin degludec 200 units/mL (degludec) versus insulin glargine 300 units/mL (glargine U300) from a Dutch societal perspective.
Methods: A previously published model estimated costs [2018 euros (EUR)] and effectiveness [quality-adjusted life years (QALYs)] with degludec compared with glargine U300 over a 1-year time horizon. The model captured hypoglycaemia rates and insulin dosing. Clinical outcomes were informed by CONCLUDE (NCT03078478), a head-to-head randomised controlled trial in insulin-experienced patients with type 2 diabetes.
Results: Treatment with degludec was associated with mean annual cost savings (EUR 24.71 per patient) relative to glargine U300, driven by a lower basal insulin dose and lower severe hypoglycaemia rate with degludec compared with glargine U300. Lower rates of non-severe nocturnal and severe hypoglycaemia resulted in improved effectiveness (+ 0.0045 QALYs) with degludec relative to glargine U300. In sensitivity analyses, changes to the vast majority of model parameters did not materially affect model outcomes.
Conclusions: This short-term analysis, informed by the latest clinical trial evidence, demonstrated that degludec was a cost-effective treatment option relative to glargine U300. As such, our modelling analysis suggests that degludec would represent an efficient use of Dutch public healthcare resources in this patient population.
Databáze: MEDLINE
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