Cost-effectiveness analysis of insulin degludec compared with insulin glargine u100 for the management of type 1 and type 2 diabetes mellitus – from the Spanish National Health System perspective

ABSTRACT

Background: The objective of this study was to assess the cost-effectiveness of insulin degludec versus insulin glargine, from the Spanish NHS in three groups of patients.

Methods: A short-term cost utility model was developed to estimate effectiveness results in terms of the total number of hypoglycaemic events and their disutility impact throughout the year on the initial level of quality of life for patients in each treatment.

Results: Degludec was the dominant strategy for T2DM BOT and exhibited an incremental cost-effectiveness ratio of 52.70€/QALY and 11,240.88€/QALY for T1DM B/B and T2DM B/B, respectively. Lower costs are primarily driven by lower nocturnal and severe hypoglycaemic events, which were reduced versus IGlar. Improvements in clinical outcomes in all three patient groups are result of the reduced number of hypoglycaemic events showing 0.0211, 0.0328 and 0.0248 QALYs gained when compared to IGlar for T1DM B/B, T2DM BOT and T2DM B/B, respectively. Different scenario analyses showed that the ICERS were stable to plausible variations in the analysed parameters, except when the same number of SMBG for both treatments is used, with T2DM B/B showing an ICER over the accepted threshold.

Conclusion: This analysis demonstrates that degludec is a cost-effective option in the Spanish NHS, when used in patients currently treated with long-acting insulin.

KEYWORDS:

• Diabetes type 1
• diabetes type 2
• insulin degludec
• insulin glargine
• hypoglycaemic episodes
• costs
• effectiveness
• ICER

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Corrigendum

Declaration of interest

P Mezquita-Raya is employed by Hospital Torrecardenas. J Darbà is employed by the University of Barcelona. M Ascanio is an employee of BCN Health Economics & Outcomes Research S.L., Barcelona, Spain, an independent contract health economic organization. A Ramírez de Arellano is employed by Novo Nordisk Pharma SA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. BCN Health Economics and Outcomes Research S.L. provided statistical analysis and editorial support. BCN Health Economics & Outcomes Research services have been funded by Novo Nordisk.

Additional information

Funding

This study was sponsored by Novo Nordisk Pharma SA.