OBJECTIVES: To evaluate the short-term cost-effectiveness of insulin degludec/insulin aspart (IDegAsp) versus insulin degludec (IDeg) and insulin aspart (IAsp) in patients with type 2 diabetes (T2DM) who needed intensification in China.

METHODS: Health economic outcomes were projected using a previously published short-term model developed in Microsoft Excel for the treatment with IDegAsp twice daily versus IDeg once daily and IAsp 2-4 times daily over a 2-year period, from Chinese healthcare perspective. Clinical input data were extracted from a randomized, controlled phase III trial (NCT01713530), and were adjusted to the average level of the Chinese population using data from the literature. China-specific costs (the averaged drug provincial biding prices until December 2019 in China) and utility were derived from published sources. Sensitivity analyses were performed assess the robustness of the results. No discounting was applied for health effects and costs for the 2-year period.

RESULTS: Over a 2-year period, treatment with IDegAsp gained 0.0073 more quality-adjusted life-years (QALYs) than treatment with IDeg and IAsp (1.5296 vs. 1.5223), with a lower cost of 6,514 CNY (24,134 vs. 30,648) per patient. The cost savings were primarily driven by lower insulin cost (8,490 vs. 9,473 CNY) which was induced by a lower daily dose of IDegAsp, lower needle cost (3,945 vs. 7,100 CNY) which was induced by a lower injections of IDegAsp ( 2 vs. 3.6 injections/day), and lower self-measured blood glucose (SMBG) test cost (7,305 vs. 10,958 CNY). Sensitivity analysis further demonstrated the robustness of the results.

CONCLUSIONS: These short-term results suggested IDegAsp is a dominant treatment intensification option compared with IDeg and IAsp from Chinese healthcare perspective for patients with T2DM, which would obtain more QALYs and reduce total medical cost.