COST-EFFECTIVENESS OF SWITCHING TO INSULIN DEGLUDEC (IDEG) IN REAL-WORLD CLINICAL PRACTICE IN ITALY
Author(s)
Haldrup S1, Lapolla A2, Gundgaard J1, Wolden ML1
1Novo Nordisk A/S, Søborg, Denmark, 2Padova University, Padova, Italy
Presentation Documents
OBJECTIVES: To evaluate the cost-effectiveness of switching to IDeg from another basal insulin in type 1 (T1D) or type 2 (T2D) diabetes in routine care. METHODS: Data were drawn from an Italian subpopulation of EU-TREAT, a multicentre, retrospective chart review study, which investigated switching from any basal insulin (± prandial insulin [± oral antidiabetic drugs in T2D]) to IDeg. Parameters in the base-case model were change in hypoglycaemia rates, basal and prandial insulin dose and body weight at 6 months post-switch and cost of treatment and complications. A 1-year, cost-effectiveness model evaluated the Incremental Cost-Effectiveness Ratio (ICER) in terms of cost per Quality-Adjusted Life Year (QALY). The robustness of the results were tested with sensitivity analyses by varying input parameters. To validate the base-case results, a lifetime horizon analysis was conducted using the IMS CORE Diabetes Model. RESULTS: Patients with T1D (n=397) were mean (SD) age 47.3 (14.5) years; previous insulin regimens were NPH 1.8%, insulin glargine U100 73.8%, insulin detemir 23.9%. Patients with T2D (n=153), were age 65.6 (9.2) years; previous insulin regimens were NPH 2.6%, insulin glargine U100 42.5%, insulin detemir 54.2%. Short-term cost per QALY gained for IDeg versus original basal insulin was estimated at €2897 for T1D (below the Italian ICER threshold of €20,000) and was dominant (lower cost and improved QALYs) in T2D. IDeg remained either highly cost-effective or dominant after elimination of any benefit in severe/non-severe hypoglycaemia, basal insulin dose and resource utilisation, in T1D and T2D. IDeg was dominant in the lifetime model for T1D and T2D and cost-savings were even greater compared with the short-term model. CONCLUSIONS: In an Italian population, switching to IDeg in routine care is highly cost-effective or dominant versus not switching basal insulin, for patients with T1D or T2D who are considered appropriate for treatment with IDeg.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PDB27
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders