OBJECTIVES

Premixed insulin and basal insulin (BI) are widely used as starter insulins in type 2 diabetes mellitus (T2DM) patients with poor glycemic control under oral antidiabetic medications (OAMs) treatment in China. Superior glycemic control of mid mixture insulin analog (MMI) over BI in the long term among Chinese patients was established in the CLASSIC pragmatic trial (NCT03018938). The present study aims to compare the average daily cost of antidiabetic treatments in T2DM patients treated with MMI or BI in combination with OAMs in China.

METHODS

Patients randomized in the CLASSIC trial with complete relevant information on antidiabetic medication were included in this cost analysis. Clinical data including drug name, daily dose and treatment duration were sourced from CLASSIC trial. Daily total medication cost (OAM & insulin), OAM cost, and insulin cost were calculated in Chinese Yuan (CNY), from the healthcare system perspective based on the retail price as of 2019. Cost of medication per patient per day in two groups was compared by student’s t-test with a two-tailed level of significance set at 0.05. Results of subgroup of patients who stayed on planned insulin treatment during 48 weeks were also reported.

RESULTS

A total of 590 patients (289 BI, 301 MMI) were included. After 48 weeks of treatment, compared with the patients on MMI, the average daily cost of total medications, OAMs and insulin for patients on BI were 38.5% (17.81±7.07 CNY vs 12.86±5.73 CNY, P<0. 0001), 51.0% (9.71±6.32 CNY vs 6.43±5.16 CNY, P<0.0001) and 25.8% (8.10±2.95 CNY vs 6.44±2.46 CNY, P<0.0001) higher, respectively. In subgroup, the average daily cost of total medications, OAMs and insulin were 41.7%, 53.3%, and 30.0% higher for patients on BI than MMI, respectively.

CONCLUSIONS

Patients treated with MMI regimen had lower average daily cost compared with BI regimen in real-world settings in China, regardless of treatment change.