OBJECTIVES: The real-world ARISE study has associated the coformulation of insulin degludec and insulin aspart (IDegAsp) with significant improvements in glycated haemoglobin (HbA1c) and body weight, factors associated with the incidence of long-term complications in type 2 diabetes, compared with a mix of prior therapies. The present study aimed to evaluate the long-term cost-effectiveness of IDegAsp versus continuing prior therapies in India.

METHODS: Clinical and cost outcomes were projected over patients’ lifetimes using the IQVIA Core Diabetes Model (v9.5+). Country-specific baseline characteristics and changes in HbA1c and body weight, as well as overall hypoglycaemic event rates, were taken from ARISE. Costs were expressed from a societal perspective in India, accounted in 2021 Indian rupees (INR). Outcomes were annually discounted at 5%. Immediate IDegAsp treatment was evaluated versus a 3-year delay.

RESULTS: In India, immediate IDegAsp was associated with life expectancy improvements of 0.05 years, and quality-adjusted life expectancy improvements of 0.12 quality-adjusted life years (QALYs), versus a 3-year delay. Combined costs in India, were estimated to INR 10,221 higher with immediate IDegAsp treatment compared with a 3-year delay, with higher treatment costs partially offset by cost savings from avoidance of diabetes-related complications and fewer days of lost productivity. IDegAsp was associated with incremental cost-effectiveness ratio of INR 87,206 per QALY gained in India compared with a 3-year delay.

CONCLUSIONS: Based on willingness-to-pay threshold of INR 200,000 per QALY gained, immediate IDegAsp therapy is likely to represent a cost-effective treatment for type 2 diabetes in India.