OBJECTIVES: To evaluate the budget impact of replacing BIAsp30 (Biphasic insulin aspart 30/70) by IDegAsp (insulin degludec+insulin aspart) in the management of type 2 diabetes mellitus (T2DM) from a Saudi Arabia public payer perspective.

METHODS: The model estimated costs before and after the replacement of BIAsp30 (Biphasic insulin aspart 30/70) with IDegAsp for 53,717 Saudi patients with T2DM over 5 years. To estimate the budget impact of replacing BIAsp30 with IDegAsp, two market scenarios were compared. In scenario 1, patients received only BIAsp30 for the entire 5-years period. In scenario 2, patients received both BIAsp30 and IDegAsp, according to projected market shares and uptake. Treatment costs include insulin acquisition, self-monitoring blood glucose (SMBG), and needles. Severe and non-severe symptomatic hypoglycemia episodes have also been identified and correlated with additional SMBG costs per hypoglycaemic episode. The model calculated the impact on the budget in 2023 Saudi Riyals (SAR) and converted to United States Dollars (USD) with a conversion rate of (1.00 SAR = 0.27 USD).

RESULTS: The total cumulative cost for 53,717 T2DM Saudi patients before and after replacing BIAsp30 with IDegAsp were estimated at 497.7 million USD and 484.4 million USD, respectively, over the five years. The total costs for patients received IDegAsp decreased by 1.16, 1.94, 2,72, 3.50, and 3.89 million USD in years 1-5, respectively, resulting in a cumulative decrease of 13.25 million USD. Over the 5 years, the cumulative insulin acquisition cost has increased the impact by 81.02 million USD. The decrease in the cumulative costs of non-severe hypoglycemia (44.85 million USD) and severe hypoglycemia (49.19 million USD) outweighed the increase in insulin acquisition costs, which reduced the overall impact.

CONCLUSIONS: IDegAsp insulin reduces the risk of hypoglycaemia, resulting in budget savings for public Saudi payers. Hypoglycaemia and its associated costs may justify the price difference between the two comparators.