Authors (author’s last name, followed by first initial)
institution(s), city, state, country |
Chang J1, Sun F1, Li H2
1Novo Nordisk (China) Pharmaceuticals Co., Ltd., Beijing, China, 2China Pharmaceutical University, Nanjing, Jiangsu, China |
Abstract (do not indent; must include OBJECTIVES, METHODS, RESULTS, CONCLUSIONS unless a Conceptual Papers submission) |
OBJECTIVES: To evaluate the long-term cost-effectiveness of switching from basal insulin to biphasic insulin aspart 30 (BIAsp30) in patients with type 2 diabetes (T2D) in China. METHODS: A published and validated computer simulation model of diabetes (CORE Diabetes Model) was used to project long-term (30 years) of health and economic outcomes. Simulated cohorts and treatment effects were derived from a 16-week , multi-centre , and single-arm trial-NCT00669864 which investigated the efficacy and safety of BIAsp30 ± Metformin in T2D patients inadequately controlled with basal insulin. Two subgroups of basal insulin treatment were categorized as insulin glargine (IGla) ± Metformin and neutral protamine hagedorn (NPH) insulin ± Metformin. The market retail prices of medications were calculated to estimate treatment costs. The diabetes management and complications costs were obtained from Chinese published data. An annual discounting rate of 3% was used for both costs and health outcomes. One-way sensitivities analysis was performed. RESULTS: Therapy conversion to BIAsp30 was projected to improve life expectancy significantly in comparison with IGla (0.347±0.245 years) , and NPH (0.452±0.242 years). Transfer to BIAsp30 was associated with improvements in 0.327 quality-adjusted life years (QALYs) over IGla , and 0.393 QALYs over NPH. Therapy conversion to BIAsp30 reduced medical costs by Chinese Yuan (CNY) 46, 540 per patient compared to IGla. However , it increased CNY 19, 525 compared to NPH and was associated with an incremental cost-effectiveness ratio of CNY 49, 730 per QALY gained. CONCLUSIONS: Therapy conversion from basal insulin to BIAsp30 in T2D patients in China was associated with improvements in life expectancy and QALYs. Transfer to BIAsp30 was cost-saving treatment strategy in T2D patients managed with IGla , and would be considered cost-effective in T2D patients managed with NPH , given a willingness-to-pay threshold of CNY 75, 375 per QALY (3 times GDP per capita in 2009) gained in China. |
