A UK Analysis of the Cost-Effectiveness of Humalog Mix75/25 and Mix50/50 Versus Long-Acting Basal Insulin
- 528 Downloads
As healthcare spending on diabetes and its complications continues to rise, the optimization of prescribed insulin regimens is becoming increasingly important from both clinical and economic perspectives. The aim of the present study was to evaluate the costeffectiveness of 75/25 biphasic insulin lispro and 50/50 biphasic insulin lispro (Humalog® Mix75/25 and Humalog® Mix50/50, respectively; Eli Lilly and Company, Indianapolis, IN, USA) compared with a long-acting analog insulin regimen in patients with type 2 diabetes.
A published and validated computer simulation model of diabetes was used to evaluate the cost-effectiveness of 75/25 and 50/50 biphasic insulin lispro versus a longacting analog insulin (insulin glargine) from the perspective of a healthcare payer in the UK. Treatment effects in terms of glycated hemoglobin (HbA1c) benefits were taken from a recent meta-analysis. Direct medical costs including pharmacy, complication, and patient management costs were obtained from published sources. All costs were expressed in 2008 British pounds sterling (GBP), and future costs and clinical benefits were discounted at 3.5% per annum. Sensitivity analyses were performed.
75/25 and 50/50 biphasic insulin lispro were associated with improvements in life expectancy of 0.09 and 0.13 years, respectively, improvements in quality-adjusted life expectancy of 0.09 quality-adjusted life years (QALYs) and 0.12 QALYs, respectively, and reductions in cost of GBP 1,217 and GBP 430, respectively, when compared with long-acting analog insulin.
Based on a recently published metaanalysis, biphasic analog insulins are likely to improve clinical outcomes and reduce costs versus long-acting analog insulins in the longterm treatment of patients with type 2 diabetes in the UK.
KeywordsBiphasic insulin Cost-effectiveness Diabetes Long-acting analog insulin United Kingdom
Unable to display preview. Download preview PDF.
- 5.Colhoun HM, Thomason MJ, Mackness MI, et al. Collaborative AtoRvastatin Diabetes Study (CARDS). Design of the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with type 2 diabetes. Diabet Med. 2002;19:201–211.Google Scholar
- 7.The NHS Information Centre, Prescribing Support and Primary Care Services. Prescribing for Diabetes in England: 2004/5 to 2009/10. Available at: http://www.ic.nhs.uk/pubs/prescribingdiabetes0410. Accessed Nov 12 2012.
- 8.Palmer AJ, Roze S, Valentine WJ, et al. The CORE Diabetes Model: Projecting long-term clinical outcomes, costs and cost-effectiveness of interventions in diabetes mellitus (types 1 and 2) to support clinical and reimbursement decision-making. Curr Med Res Opin. 2004;20(Suppl. 1): S5–26.PubMedCrossRefGoogle Scholar
- 13.National Health Service Electronic Drug Tariff 2009. Available at: http://www.ppa.org.uk/ppa/drug_tariff_back_copies.htm. Accessed May 12 2010.
- 14.UK Office for National Statistics. Consumer Price Indices. Available at: http://www.statistics.gov.uk/statbase/Product.asp?vlnk=10919. Accessed May 20 2010.
- 15.World Health Organization Collaborating Centre for Drug Statistics Methodology. Anatomical Therapeutic Chemical/Defined Daily Dose Index 2010. Available at: http://www.whocc.no/atc_ddd_index/?code=A10AE. Accessed May 11 2010.
- 16.National Institute for Health and Clinical Excellence. Guide to the Methods of Technology Appraisal (reference N0515). Available at: http://www.nice.org.uk/niceMedia/pdf/TAP_Methods.pdf. Accessed May 11 2010.
- 23.Nathan DM, Buse JB, Davidson MB, et al. American Diabetes Association; European Association for Study of Diabetes. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009;32:193–203.PubMedCrossRefGoogle Scholar
- 24.National Institute for Health and Clinical Excellence. CG87 Type 2 diabetes - newer agents (a partial update of CG66): NICE guideline. Available at: http://www.nice.org.uk/nicemedia/live/12165/44320/44320.pdf. Accessed Nov 7 2012.
- 27.Data on file: USA; Eli Lilly and Company, 2010.Google Scholar