OBJECTIVES: To assess the short-term cost-effectiveness of switching to Insulin degludec (degludec) from current basal insulin treatment in Japanese patients with type 2 diabetes (T2DM) on basal bolus (B/B) therapy, using Japanese real world evidence (RWE) data from a prospective observational study.

METHODS: A previously published transparent open-source model in Excel was used to assess the short-term cost-effectiveness, in terms of cost per quality-adjusted life year (QALY), over a 1-year period after switching patients to degludec from their current basal insulin in their B/B treatment. Model input data for incidence of hypoglycemia and insulin doses were obtained from a Japanese prospective observational study to estimate the cost per QALY. Model inputs and assumptions related to hypoglycemia outcomes, treatment costs and utility related to dosing flexibility were varied and assessed in sensitivity analyses. Baseline data from the RWE study were used to make the comparison with the patients switching to degludec.

RESULTS: In the base case scenario, and across all sensitivity analyses, switching patients to degludec from their current basal insulin was found to be a cost-effective intervention. Incremental costs over 1 year in the base case was JPY 9510 with an associated QALY gain of 0.0354, resulting in an incremental cost-effectiveness ratio (ICER) of JPY 268,811 per QALY gained. The ICERs across the sensitivity analyses were all well below the willingness-to-pay (WTP) threshold of JPY 5 million that has been used in the health technology assessment (HTA) pilot in Japan.

CONCLUSIONS: Based on Japanese RWE data, switching T2DM patients on B/B therapy from their current basal insulin to degludec was found to be highly cost-effective in a Japanese setting. These findings may inform decision makers in Japan to make cost-effective treatment decisions.