OBJECTIVES : The aim of this study was to evaluate the long-term cost-utility of insulin degludec (degludec) versus insulin glargine 100 units/ml (glargine) for the treatment of type 2 diabetes (T2DM) receiving basal–bolus insulin therapy in China.

METHODS : A cost-effectiveness analysis was performed using the validated IMS CORE Diabetes Model (CDM) over 30 year horizon. Patient characteristics and clinical effects were obtained from subgroup results of KIDUNA study in East Asian population which was a one year, prospective real world study under the conditions of routine clinical practice. China-specific costs (the most current drug provincial biding price in china) were obtained from the literature. An annual discounting rate of 3% was used for both health and cost outcomes, and one-way sensitivities analysis was conducted to assess the robustness of the results.

RESULTS : Degludec was associated with an improved discounted gain in quality-adjusted life-years (QALYs) of 1.13 (8.50 [standard deviation 0.11] versus 7.37 [standard deviation 0.10]) compared to glargine. Improved clinical outcomes resulted from lower cumulative incidence of diabetes-related complications. The CDM predicted lower estimated direct lifetime healthcare costs of CNY 7,004.38 for patients switching to degludec. Lower overall costs were primarily driven by lower incidence of severe hypoglycaemic events due to the significant reduction in number of events with degludec versus glargine. The incremental cost-effectiveness ratio (ICER) showed degludec as dominant (i.e. higher effectiveness with a lower cost). Sensitivity analyses confirmed the results.

CONCLUSIONS : For patients with T2DM receiving basal–bolus insulin therapy in China, degludec is a cost saving treatment option compared with glargine.