Real-world cost-effectiveness of insulin degludec in type 1 and type 2 diabetes mellitus from a Swedish 1-year and long-term perspective
| Autor: | Jens Gundgaard, Ann Charlotte Mårdby, Barnaby Hunt, Åsa Ericsson, Johan Jendle, Joao Diogo Da Rocha Fernandes, Bertil Ekman, Samuel J. P. Malkin, Maria Thunander, Stefan Sjöberg |
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| Rok vydání: | 2020 |
| Předmět: |
Insulin degludec
Pediatrics medicine.medical_specialty endocrine system diseases Cost effectiveness Cost-Benefit Analysis Type 2 diabetes Diabetes Complications 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Cost of Illness medicine Humans Hypoglycemic Agents Glycated Hemoglobin Sweden Type 1 diabetes Dose-Response Relationship Drug business.industry 030503 health policy & services Health Policy nutritional and metabolic diseases Type 2 Diabetes Mellitus Health Services medicine.disease Hypoglycemia Insulin Long-Acting Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 chemistry Basal (medicine) 030220 oncology & carcinogenesis Quality-Adjusted Life Years Glycated hemoglobin Health Expenditures 0305 other medical science business Models Econometric |
| Zdroj: | Journal of Medical Economics. 23:1311-1320 |
| ISSN: | 1941-837X 1369-6998 |
| Popis: | Background and Aims: The ReFLeCT study demonstrated that switching to insulin degludec from other basal insulins was associated with reductions in glycated hemoglobin and hypoglycemic events in type 1 (T1D) and type 2 diabetes (T2D), and reductions in insulin doses in T1D. The aim of the present analysis was to assess the short- and long-term cost-effectiveness of switching to insulin degludec in Sweden. Methods: Short-term outcomes were evaluated over 1 year in a Microsoft Excel model, while long-term outcomes were projected over patient lifetimes using the IQVIA CORE Diabetes Model. Cohort characteristics and treatment effects were sourced from the ReFLeCT study. Costs (in 2018 Swedish krona [SEK]) encompassed direct medical expenditure and indirect costs from loss of workplace productivity. In the long-term analyses, patients were assumed to receive insulin degludec or continue prior insulin therapy (primarily insulin glargine U100) for 5 years, before all patients intensified to once-daily degludec and mealtime aspart. Results: Switching to insulin degludec was associated with improved quality-adjusted life expectancy of 0.04 and 0.02 quality-adjusted life years (QALYs) over 1 year, and 0.16 and 0.08 QALYs over patient lifetimes, in T1D and T2D. Combined costs in T1D and T2D were estimated to be SEK 1 249 lower and SEK 1 181 higher over the short term, and SEK 157 258 and SEK 2 114 lower over the long term. Benefits were due to lower insulin doses in T1D, reduced rates of hypoglycemia and lower incidences of diabetes-related complications. Insulin degludec was associated with an incremental cost-effectiveness ratio of SEK 64 298 per QALY gained for T2D over 1 year and considered dominant for T1D and T2D in all other comparisons. Conclusions: Insulin degludec was projected to be cost-effective or dominant versus other basal insulins for the treatment of T1D and T2D in Sweden. |
| Databáze: | OpenAIRE |
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