Comparison of treatment costs in inadequately controlled type 2 diabetes in Germany based on the APOLLO trial with insulin glargine

Figures & data

Figure 1. Sensitivity analysis: cost savings of glargine versus lispro per patient per year*.

Figure 2. Monte Carlo simulation results on annual insulin consumption. (a) Probability of specific cost differences in annual insulin medication costs; (b) frequency (%) of specific cost savings in total annual therapy costs.

Table 1. Resource use, unit costs and cost estimates in €/patient/year: base case cost analysis.

Resource use	Consumption/year		Unit costs, €		Costs, €/year (%)		Difference in costs (€)
	Glargine	Lispro	Glargine	Lispro	Glargine	Lispro
Insulin (U)*	13,317	15,032	By pack size: small: 0.050/U medium: 0.053/U large: 0.059/U	By pack size: small: 0.047/U large: 0.043/U	693.09 (64.6)	655.74 (36.5)	37.35
Needles	365 in each case	1095 in each case	0.269/needle		98.22 (9.2)	294.66 (16.4)	−196.44
Blood glucose test strips	As above		0.658/test strip		240.17 (22.4)	720.51 (40.2)	−480.34
Lancets	As above		0.113/lancet		41.15 (3.8)	123.46 (6.9)	−82.31
Total costs, €/year					1,072.64	1,794.37	−721.74

*Distribution of insulin glargine pack sizes according to the APOLLO study. The form of insulin administration with both preparations using disposable pens (glargine: Optiset; lispro: Humalog).

Table 2. Sensitivity analysis: results with modified assumptions.

Modified assumption	Resulting cost savings with glargine, €/patient/year	Change from base case (%)
Needle consumption in both group groups, one needle per ten injections	544.94	176.8 (24.5)
Glimepiride costs included in both treatment groups: packs with 28 tablets	718.99	2.75 (0.4)
Glimepiride costs included in both treatment groups: packs with 112 tablets	718.43	3.31(0.5)
Discontinuation of sulphonylureas in the prandial lispro group: packs with 28 tablets	559.74	162 (22.4)
Discontinuation of sulphonylureas in the prandial lispro group: packs with 112 tablets	601.74	120 (16.6)
Both treatment groups one blood glucose measurement daily	159.09	562.65 (78.0)
Costs of severe hypoglycaemia: one glucagon injection, one blood glucose measurement	723.16	1.42 (0.2)
Costs with confirmed symptomatic hypoglycaemia: one blood glucose measurement (2.12 events vs. 9.10 events per patient per year)	727.16	5.42 (0.8)
Insulin glargine: pack size based on actual market distribution^19	723.49	1.75 (0.2)
Insuman rapid used in place of insulin lispro	556.41	165.33 (22.9)
Addition of short-acting insulin lispro three times daily to one-third of patients initiated on insulin glargine	83.83	637.91 (88.4%)

Schwabe U, Paffrath D. Arzneiverordnungs - Report 2007, Aktuelle Daten, Kosten Trends und Kommentare. Heidelberg: Springer Medizin Verlag, 2008

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