LONG-TERM COST UTILITY ANALYSIS OF IDEGLIRA VERSUS BASAL-BOLUS INSULIN INTENSIFICATION THERAPIES IN PATIENTS WITH TYPE 2 DIABETES INADEQUATELY CONTROLLED ON BASAL INSULIN IN SPAIN
Author(s)
Prades M1, Lizan L2, Hunt B3, Ramirez de Arellano A4
1Outcomes'10, Castellon, Spain, 2Outcomes 10, Castellon, Spain, 3Ossian, Basel, Switzerland, 4Novo Nordisk Ltd, Madrid, Spain
OBJECTIVES: Compare the long-term cost-effectiveness of IDegLira and basal-bolus insulin as two alternative insulin intensification therapies in patients with type 2 diabetes (T2DM) uncontrolled on basal insulin from the perspective of the Spanish Health System. METHODS: The analysis was carried out using the validated and published IMS CORE Diabetes Model. Treatment effects were applied from an indirect comparative analysis using treatment arms from five randomized clinical trials, involving T2DM patients uncontrolled on basal insulin, with similar insulin titration goals. The utilities associated with diabetes and their complications were taken from published sources and included in the model. The model estimated long-term outcomes (50 years) such as: life years (LY), quality-adjusted life years (QALY), cumulative incidence of diabetes-related complications, time to onset of diabetes-related complications and costs. The incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR) were estimated. RESULTS: IDegLira was associated with increased discounted life years (14.35 versus 14.17 years) and discounted QALYs (9.17 versus 8.81 QALYs) versus basal-bolus insulin therapy. IDegLira also presented a reduction in incidence and time to onset of diabetes-related complications. Life time cost per patient was lower with IDegLira than basal-bolus insulin (€54,078 versus €54,748). One of the key drivers of the results is the relatively good performance of IDegLira in terms of reduction in severe and non-severe hypoglycaemia. ICER estimations and univariate and probabilistic sensitivity analysis showed that IDegLira is a dominant treatment (i.e. less costly and more effective) compared to basal-bolus insulin. CONCLUSIONS: IDegLira is a less costly and more effective alternative for the treatment of patients with T2DM uncontrolled on basal insulin compared with basal-bolus insulin therapy.
Conference/Value in Health Info
2016-05, ISPOR 2016, Washington DC, USA
Value in Health, Vol. 19, No. 3 (May 2016)
Code
PRM156
Topic
Methodological & Statistical Research
Topic Subcategory
Confounding, Selection Bias Correction, Causal Inference
Disease
Diabetes/Endocrine/Metabolic Disorders