The Long-Term Cost-Effectiveness of Insulin Icodec vs. Once-Daily Basal Insulin Analogs in Italy
Author(s)
Giorgia Guareschi, MSc1, Aparajita Tyagi, MSc2, Lucia Sara D'Angiolella, PharmD1, Juliette Cattin, MSc3, Barnaby Hunt, MSc3, Samuel JP Malkin, MSc3.
1Novo Nordisk S.P.A., Rome, Italy, 2Novo Nordisk A/S, Bagsværd, Denmark, 3Ossian Health Economics and Communications GmbH, Basel, Switzerland.
1Novo Nordisk S.P.A., Rome, Italy, 2Novo Nordisk A/S, Bagsværd, Denmark, 3Ossian Health Economics and Communications GmbH, Basel, Switzerland.
OBJECTIVES: Daily basal insulin injections remain a cornerstone of type 2 diabetes (T2D) management, yet their frequency can impose a considerable burden on patients’ quality of life. Icodec is a novel once-weekly basal insulin associated with significantly improved glycated hemoglobin versus once-daily insulins glargine U100, degludec, and a mix of degludec, glargine U100 and U300 in the ONWARDS 1, 3 and 5 clinical trials, respectively. Based on these consistent clinical benefits, the present study evaluated the long-term cost-effectiveness of icodec for treating insulin-naïve people with T2D in Italy.
METHODS: Outcomes were projected over patient lifetimes using the PRIME T2D Model. ONWARDS 1, 3 and 5 informed baseline characteristics and treatment effects in the comparisons of icodec with glargine U100, degludec, and the mix of once-daily basal insulins, respectively. Modeled patients received basal insulin for 4 years before intensifying to basal-bolus insulin, with differences in treatment effects and a quality-of-life benefit for once-weekly versus once-daily injection maintained until intensification. Costs and utilities were taken from published sources, with costs expressed in euros (EUR) from the perspective of the Italian National Health Service.
RESULTS: Icodec was associated with improved quality-adjusted life expectancy of 0.16 quality-adjusted life years (QALYs) versus glargine U100 and degludec, and 0.26 QALYs versus the mix of once-daily insulins, and higher direct costs of EUR 4,190, EUR 893 and EUR 1,017, respectively, with increased treatment costs partially offset by avoidance of diabetes-related complications. Icodec was associated with incremental cost-effectiveness ratios of EUR 25,623, EUR 5,438 and EUR 3,940 per QALY gained versus glargine U100, degludec, and the mix of once-daily insulins, respectively.
CONCLUSIONS: Based on a willingness-to-pay range of EUR 25,000-40,000 per QALY gained, icodec was projected to be highly cost-effective for treating insulin-naïve people with T2D in Italy, resulting from a reduced injection burden and a lowered incidence of diabetes-related complications.
METHODS: Outcomes were projected over patient lifetimes using the PRIME T2D Model. ONWARDS 1, 3 and 5 informed baseline characteristics and treatment effects in the comparisons of icodec with glargine U100, degludec, and the mix of once-daily basal insulins, respectively. Modeled patients received basal insulin for 4 years before intensifying to basal-bolus insulin, with differences in treatment effects and a quality-of-life benefit for once-weekly versus once-daily injection maintained until intensification. Costs and utilities were taken from published sources, with costs expressed in euros (EUR) from the perspective of the Italian National Health Service.
RESULTS: Icodec was associated with improved quality-adjusted life expectancy of 0.16 quality-adjusted life years (QALYs) versus glargine U100 and degludec, and 0.26 QALYs versus the mix of once-daily insulins, and higher direct costs of EUR 4,190, EUR 893 and EUR 1,017, respectively, with increased treatment costs partially offset by avoidance of diabetes-related complications. Icodec was associated with incremental cost-effectiveness ratios of EUR 25,623, EUR 5,438 and EUR 3,940 per QALY gained versus glargine U100, degludec, and the mix of once-daily insulins, respectively.
CONCLUSIONS: Based on a willingness-to-pay range of EUR 25,000-40,000 per QALY gained, icodec was projected to be highly cost-effective for treating insulin-naïve people with T2D in Italy, resulting from a reduced injection burden and a lowered incidence of diabetes-related complications.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE717
Topic
Economic Evaluation
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)