OBJECTIVES: Gla-300 is developed as a second generation basal insulin analogue that provides comparable efficacy to Gla-100, but with the advantages of providing a lower hypoglycemic risk especially at nocturnal period, and improved glycemic variability. The study aims to analyze the cost-utility of Gla-300 compared to Gla-100 in patients with T2DM in Thailand setting.

METHODS

: One-year cost-utility analysis of Gla-300 vs Gla-100 was conducted by assessing clinical and economic outcome under Thai context. Hypoglycemic rate were calculated using data from EDITION II and III. Utilities with hypoglycemia and injection flexibility time were derived from literature review. Data included drug cost and cost of severe hypoglycemic event derived from official government website and Thai literature. Gla-300 has cost per unit parity to Gla-100 but with 14% higher unit dose per day. The threshold of THB 160,000 (USD 4,533) per Quality-Adjusted Life Years (QALYs) suggested by Thailand Health Technology Assessment (HTA) guideline was considered in this study. One-way and probabilistic sensitivity analyses (PSA) were performed to assess parameters uncertainty.

RESULTS

: The base-case analysis showed that Gla-300 was associated with higher QALY (0.0137) caused by reducing hypoglycemia rate and offering more injection flexibility. 14% dose increase of Gla-300 comparing Gla-100 was partially offset by the benefit of reducing severe hypoglycemic event, resulting in a slightly incremental cost of THB 1,121 ($ 32) per year. The incremental cost-effectiveness ratio (ICER) was THB 81,888 ($ 2,320) per QALY gained assuming cost-effective under the threshold. At the threshold of THB 160,000 per QALY gained, the result showed a probability of 59% for Gla-300 of being cost-effective as compared to Gla-100.

CONCLUSIONS: Gla-300 is a second generation basal insulin analog offering lower hypoglycemia and improved glycemic variability in T2DM. Over 1-year period, Gla-300 was considered cost-effective as compared to Gla-100 in Thailand setting.