Long-Term Cost-Effectiveness Analysis of Once-Weekly Insulin Icodec Versus Once-Daily Basal Insulin Analogues in Patients With Type 2 Diabetes in China
Author(s)
Xichen Tong, PhD1, Chang Xing, M.S.2, Zhang Lei, 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 is the world’s first once-weekly basal insulin analogue approved in 2024 in China. This study aimed to evaluate the long-term cost-effectiveness of icodec compared with once-daily basal insulin analogues among Chinese type 2 diabetes (T2D) patients.
METHODS: The validated IHE Diabetes Cohort Model, constructed from Markov health states for macrovascular and microvascular complications, was applied in this study. Model inputs of baseline characteristics and treatment effects were derived from the ONWARDS 5 clinical trial, which compared icodec used with dosing guide app with once-daily basal insulins (glargine U100, glargine U300, and degludec). Complication costs and utilities were sourced from publications, and costs were expressed in 2023 US dollar ($). The annual drug costs of icodec and other insulins were calculated based on the Chinese national reimbursement drug list payment standard and national insulin volume-based procurement in 2024. From Chinese healthcare system perspective, the model was simulated for 40 years with a 5% discount rate. Scenario analyses of icodec versus subgroup insulins were also investigated. Both one-way and probabilistic sensitivity analyses were conducted to validate the robustness of base case results.
RESULTS: Insulin icodec improved quality-adjusted life years (QALYs) by 0.261 QALYs (7.290 vs 7.029) and reduced medical costs by $2,569.71 ($46,082.71 vs $48,652.56) compared with basal insulin analogues. Macrovascular and microvascular costs were $136.94 and $466.74 lower with icodec than with the comparator group. Scenario analyses showed that icodec was dominant versus glargine U100 and degludec (ΔQALY 0.303, 0.275; Δcost $-4,198.14, $-2,662.95 respectively). Icodec was projected to be cost-effective versus glargine U300 with ICER $4,604.57 /QALY (ΔQALY 0.053, Δcost $242.67), which was below 0.4-time GDP per capita in China. Sensitivity analyses verified the robustness of base case results.
CONCLUSIONS: Once-weekly insulin icodec is a cost-effective treatment option compared to once-daily basal insulin analogues in China.
METHODS: The validated IHE Diabetes Cohort Model, constructed from Markov health states for macrovascular and microvascular complications, was applied in this study. Model inputs of baseline characteristics and treatment effects were derived from the ONWARDS 5 clinical trial, which compared icodec used with dosing guide app with once-daily basal insulins (glargine U100, glargine U300, and degludec). Complication costs and utilities were sourced from publications, and costs were expressed in 2023 US dollar ($). The annual drug costs of icodec and other insulins were calculated based on the Chinese national reimbursement drug list payment standard and national insulin volume-based procurement in 2024. From Chinese healthcare system perspective, the model was simulated for 40 years with a 5% discount rate. Scenario analyses of icodec versus subgroup insulins were also investigated. Both one-way and probabilistic sensitivity analyses were conducted to validate the robustness of base case results.
RESULTS: Insulin icodec improved quality-adjusted life years (QALYs) by 0.261 QALYs (7.290 vs 7.029) and reduced medical costs by $2,569.71 ($46,082.71 vs $48,652.56) compared with basal insulin analogues. Macrovascular and microvascular costs were $136.94 and $466.74 lower with icodec than with the comparator group. Scenario analyses showed that icodec was dominant versus glargine U100 and degludec (ΔQALY 0.303, 0.275; Δcost $-4,198.14, $-2,662.95 respectively). Icodec was projected to be cost-effective versus glargine U300 with ICER $4,604.57 /QALY (ΔQALY 0.053, Δcost $242.67), which was below 0.4-time GDP per capita in China. Sensitivity analyses verified the robustness of base case results.
CONCLUSIONS: Once-weekly insulin icodec is a cost-effective treatment option compared to once-daily basal insulin analogues in China.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE522
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)