Cost-Effectiveness of Switching Insulin Therapies for Diabetes


A recent analysis of real-world data has shown that switching insulin therapies is highly cost-effective for the treatment of type 1 and type 2 diabetes, presented at the International Society for Pharmacoeconomics and Outcomes Research 20th Annual European Congress (November 4-8, 2017; Glasgow, Scotland).

Previously reported real-world evidence found that switching to insulin degludec (Tresiba, Novo Nordisk) from other basal insulins—including glargine U100 and insulin detemir—offers significant reductions in blood glucose levels. Such a treatment switch has also shown to lower the rates of severe hypoglycemic episodes by 92% and 85% in patients with type 2 diabetes and type 1 disease, respectively.

A recent analysis was conducted based on an Italian subpopulation of the European Tresiba Audit study, which is a multicenter, real-world evidence study based in Europe that includes 2550 patients. The study examined the effect of switching to insulin degludec from another basal insulin patients with type 1 (n = 397) and type 2 (n = 153) disease.

Cost-effectiveness was assessed by changes in hypoglycemic rates, basal and prandial insulin dose, body weight at 6 months after switching to insulin degludec, and cost of treatment and complications. Researchers evaluated the incremental cost-effectiveness ratio (ICER) for cost per quality-adjusted life year (QALY).

Results of the study showed that insulin degludec remained cost-effective after excluding key benefits associated with switching to the drug, including reductions in hypoglycemia and the use of health system resources in a 1-year treatment period. Short-term cost per QALY gained for patients receiving insulin degludec was estimated at €2897 in type 1 diabetes and was dominant (lower cost and improved QALYs) in type 2 diabetes.


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Additionally, after estimating the lifetime costs of type 1 and type 2 diabetes, cost savings were found to be even greater after switching to insulin degludec.

"In addition to the body of evidence supporting its benefits in clinical practice, Tresiba has been shown to be a cost-effective treatment option across various European healthcare systems," commented Mads Krogsgaard Thomsen, executive vice president and chief science officer, Novo Nordisk, in a statement (November 6, 2017). "We hope these encouraging findings from real-world clinical practice will help make Tresiba available to even more people living with type 1 and type 2 diabetes around the world."—Zachary Bessette