ISPOR 2025
Tuesday, May 13 - Friday, May 16
Long-Term Cost-Effectiveness of Once-Weekly Insulin Icodec Versus Degludec for the Treatment of Patients With Type 2 Diabetes Mellitus in China
Author(s)
Xichen Tong, PhD1, Zhang Lei, M.S.2, Yawen Zhang, M.S.2, Luying Zhang, PhD1.
1Fudan University, Shanghai, China, 2Novo Nordisk (China) Pharmaceutical Co. Ltd., Beijing, China.
1Fudan University, Shanghai, China, 2Novo Nordisk (China) Pharmaceutical Co. Ltd., Beijing, China.
OBJECTIVES: Insulin icodec, the first once-weekly basal insulin analogue for diabetes management around the world, was approved in China in 2024. This analysis aimed to evaluate the long-term cost-effectiveness of once-weekly insulin icodec compared to once-daily insulin degludec in patients with type 2 diabetes mellitus (T2DM) in China.
METHODS: This study employed the validated IHE Diabetes Cohort Model, constructed from numerous Markov health states of diabetes-related microvascular and macrovascular complications. Baseline characteristics and treatment effects were derived from ONWARDS 3 trial. Annual treatment costs of anti-diabetes medications were calculated based on national reimbursement drug list payment standard and national insulin volume-based procurement in 2024. Data on the cost and utility of complications were mainly sourced from published literature on T2DM patients in China, and costs were inflated to 2023 US dollar ($). Analyses were conducted from Chinese healthcare system perspective over a time horizon of 40 years with a 5% discounted rate. The robustness of the results was evaluated through one-way and probabilistic sensitivity analysis.
RESULTS: Compared with degludec, icodec was associated with a 0.024-year increase in life expectancy (13.263 vs. 13.239) and a 0.212 QALY gain (8.676 vs. 8.464). The health benefits of icodec were derived from lower cumulative incidences of background retinopathy (33.47% vs. 37.92%), proliferative retinopathy and macular edema (3.35% vs. 4.36%), severe visual loss (5.57% vs. 6.25%), neuropathy (6.88% vs. 7.69%), macroalbuminuria (15.51% vs. 17.71%), end-stage renal disease (8.52% vs. 9.50%) and cardiovascular disease (29.96% vs. 30.35%). Icodec was associated with cost savings of $971.94 ($39,778.05 vs. $40,750.00), which was due to reduction in the costs of microvascular and macrovascular complication by $532.73 and $52.08, and treatment costs by $387.13. Sensitivity analyses verified the robustness of base case results.
CONCLUSIONS: Compared with insulin degludec, insulin icodec represents a dominant treatment option for patients with T2DM in China.
METHODS: This study employed the validated IHE Diabetes Cohort Model, constructed from numerous Markov health states of diabetes-related microvascular and macrovascular complications. Baseline characteristics and treatment effects were derived from ONWARDS 3 trial. Annual treatment costs of anti-diabetes medications were calculated based on national reimbursement drug list payment standard and national insulin volume-based procurement in 2024. Data on the cost and utility of complications were mainly sourced from published literature on T2DM patients in China, and costs were inflated to 2023 US dollar ($). Analyses were conducted from Chinese healthcare system perspective over a time horizon of 40 years with a 5% discounted rate. The robustness of the results was evaluated through one-way and probabilistic sensitivity analysis.
RESULTS: Compared with degludec, icodec was associated with a 0.024-year increase in life expectancy (13.263 vs. 13.239) and a 0.212 QALY gain (8.676 vs. 8.464). The health benefits of icodec were derived from lower cumulative incidences of background retinopathy (33.47% vs. 37.92%), proliferative retinopathy and macular edema (3.35% vs. 4.36%), severe visual loss (5.57% vs. 6.25%), neuropathy (6.88% vs. 7.69%), macroalbuminuria (15.51% vs. 17.71%), end-stage renal disease (8.52% vs. 9.50%) and cardiovascular disease (29.96% vs. 30.35%). Icodec was associated with cost savings of $971.94 ($39,778.05 vs. $40,750.00), which was due to reduction in the costs of microvascular and macrovascular complication by $532.73 and $52.08, and treatment costs by $387.13. Sensitivity analyses verified the robustness of base case results.
CONCLUSIONS: Compared with insulin degludec, insulin icodec represents a dominant treatment option for patients with T2DM in China.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE101
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)