An analysis of the cost-effectiveness of switching from biphasic human insulin 30, insulin glargine, or neutral protamine Hagedorn to biphasic insulin aspart 30 in people with type 2 diabetes

Abstract

Aims:

The aim of this analysis was to assess the cost-effectiveness of switching from biphasic human insulin 30 (BHI), insulin glargine (IGlar), or neutral protamine Hagedorn (NPH) insulin (all ± oral glucose-lowering drugs [OGLDs]) to biphasic insulin aspart 30 (BIAsp 30) in people with type 2 diabetes in India, Indonesia, and Saudi Arabia.

Methods:

The IMS CORE Diabetes Model was used to determine the clinical outcome, costs, and cost-effectiveness of switching from treatment with BHI, IGlar, or NPH to BIAsp 30 over a 30-year time horizon. A 1-year analysis was also performed based on quality-of-life data and treatment costs. Incremental cost-effectiveness ratios (ICERs) were expressed as a fraction of gross domestic product (GDP) per capita, and cost-effectiveness was defined as ICER <3-times GDP per capita.

Results:

Switching treatment from BHI, IGlar, or NPH to BIAsp 30 was associated with an increase in life expectancy of >0.7 years, reduction in all diabetes-related complications, and was considered as cost-effective or highly cost-effective in India, Indonesia, and Saudi Arabia (BHI to BIAsp 30, 0.26 in India, 1.25 in Indonesia, 0.01 in Saudi Arabia; IGlar to BIAsp 30, −0.68 in India, −0.21 in Saudi Arabia; NPH to BIAsp 30, 0.15 in India, −0.07 in Saudi Arabia; GDP per head per annum/quality-adjusted life-year). Cost-effectiveness was maintained in the 1-year analyses.

Conclusions:

Switching from treatment with BHI, IGlar, or NPH to BIAsp 30 (all ± OGLDs) was found to be cost-effective in India, Indonesia, and Saudi Arabia, both in the long and short term.

Key words: :

• A₁chieve
• Type 2 diabetes mellitus
• Cost-effectiveness
• Saudi Arabia
• India
• Indonesia
• Biphasic insulin aspart 30

Transparency

Declaration of funding

Funded by Novo Nordisk.

Declaration of financial/other relationships

VG, AS, and RB, for themselves or institutions with which they are associated, receive funding from all major international pharmaceutical companies for their advisory, lecturing, and research activities, including from Novo Nordisk. EH and AN are employees of Novo Nordisk.

Acknowledgments

We thank all the participants and investigators who helped with the A₁chieve study. The authors take full responsibility for the data and analysis supporting this article, and the results and discussion presented, but acknowledge editorial assistance from Kirsty Ratcliffe of Watermeadow Medical and Last Mile P/S for assistance with analyses.

ClinicalTrials.gov trial identifier: NCT00869908.