OBJECTIVES

Short-acting insulin analogues (aspart, lispro and glulisine) are widely used in diabetes management. The efficacy and safety are well established for these drugs, however they have different pharmacokinetic characteristics and costs. The aim of this study is to analyze the differences among the short-acting insulin analogues available today, focusing on the opportunity to optimize therapy management costs.

METHODS

A budget impact model was developed to estimate the impact of a redistribution of the short-acting insulin analogues use (39% IAsp: 15% IGlu: 43% ILsp: 3% ILspBIos), according to clinical and economic considerations. The analysis involved two scenarios: in the first, the entire population (731.000) was considered and more equal market shares were assumed: (36% IAsp : 18% IGlu : 31% ILsp: 15% ILspBIos); in the second scenario two subgroups were evaluated, working age subgroup (181.202) and high-dose insulin user subgroup (35.482). In the working age subgroup market shares redistribution was the same adopted in the entire population scenario (36% IAsp : 18% IGlu : 31% ILsp: 15% ILspBIos), while in the high-dose insulin user subgroup, the impact of the switch to the biosimilar of insulin lispro analogue (100% ILspBIos) was evaluated. The analysis was conducted from the perspective of the Italian National Health Service over a 1-year time horizon. Market shares were derived from market analyses and retail price was adopted for drugs cost.

RESULTS

The first scenario results showed savings for the INHS equal to € 6,264,451, which rose to € 12,873,580 in the second scenario considering the effects into specific subgroups. The robustness of the results was demonstrated by the sensitivity analysis.

CONCLUSIONS

The results of the analysis highlight that a more appropriate use of short-acting insulin analogues can allow significant savings for the NHS, involving an optimization of the clinical and economic management of the therapy.