Affiliations 

  • 1 Universiti Sains Malaysia, Georgetown, Penang, Malaysia
  • 2 Jaslok Hospital and Research Centre, Mumbai, India
  • 3 Pharmacoeconomics Centre of KSMC, Riyadh, Saudi Arabia
  • 4 Novo Nordisk A/S, Søborg, Denmark
  • 5 Newcastle University, Newcastle upon Tyne, UK. Electronic address: philip.home@newcastle.ac.uk
Diabetes Res Clin Pract, 2014 Nov;106(2):319-27.
PMID: 25305133 DOI: 10.1016/j.diabres.2014.08.024

Abstract

Aim: This study aimed to assess the cost-effectiveness of starting insulin therapy with biphasic insulin aspart 30 (BIAsp 30) in people with type 2 diabetes inadequately controlled on oral glucose-lowering drugs in Saudi Arabia, India, Indonesia, and Algeria.

Methods: The IMS CORE Diabetes Model was used to evaluate economic outcomes associated with starting BIAsp 30, using baseline characteristics and treatment outcomes from the A(1)chieve study. Time horizons of 1 and 30 years were applied, with country-specific costs for complications, therapies, and background mortality. Incremental cost-effectiveness ratios (ICERs) are expressed as cost per quality-adjusted life-year (QALY) in local currencies, USD, and fractions of local GDP per capita (GDPc). Cost-effectiveness was pre-defined using the World Health Organization definition of <3.0 times GDPc. Comprehensive sensitivity analyses were performed.

Results: In the primary 30-year analyses, starting BIAsp 30 was associated with a projected increase in life expectancy of >1 year and was highly cost-effective, with ICERs of -0.03 (Saudi Arabia), 0.25 (India), 0.48 (India), 0.47 (Indonesia), and 0.46 (Algeria) GDPc/QALY. The relative risk of developing selected complications was reduced in all countries. Sensitivity analyses including cost of self-monitoring, treatment costs, and deterioration of glucose control with time showed the results to be robust. In a 1-year analysis, ICER per QALY gained was still cost-effective or highly cost-effective.

Conclusion: Starting BIAsp 30 in people with type 2 diabetes in the A(1)chieve study was found to be cost-effective across all country settings at 1- and 30-year time horizons, and usefully increased predicted life expectancy.

Keywords: A(1)chieve; Biphasic insulin aspart 30; Cost-effectiveness; Type 2 diabetes mellitus.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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