Cost-effectiveness of switching to biphasic insulin aspart in poorly-controlled type 2 diabetes patients in China

Section: Costs and Perspectivementioning

confidence: 99%

Cost-Effectiveness of Switching Patients with Type 2 Diabetes from Insulin Glargine to Insulin Detemir in Chinese Setting: A Health Economic Model Based on the PREDICTIVE Study

Yang

Christensen

Sun³

et al. 2012

“…Costs for vascular events included fatal and non-fatal costs (applied in the year when the event occurred) and maintenance costs (applied in subsequent years if patients survived or simulation horizon was not reached); and the costs were primarily based on a published Chinese study [67]. As the costs of ulcers were not available, they were derived by synthesizing data from other published studies [68][69] (Table 4).…”

Section: Costsmentioning

confidence: 99%

“…a Costs for vascular events were primarily based on a published Chinese study [67]. Costs of ulcer were derived by synthesizing data from other published studies [68][69]. Costs for severe hypoglycemia [70], urinary tract infection and genital infection [71] were taken from published studies.…”

Section: Costsmentioning

confidence: 99%

Cost-Effectiveness of Dapagliflozin Versus Acarbose as A Monotherapy in Type 2 Diabetes in China

2016

ObjectiveTo estimate the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in treatment-naïve patients with type 2 diabetes mellitus (T2DM) in China. MethodsThe Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed. ResultsThe model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust. ConclusionDapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with a little QALY gain and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of T2DM.

“…For those surviving the event, maintenance costs were applied in all subsequent years until patient death or the simulation ends. The costs were estimated based largely on Gao et al [52]; when the direct cost of a diabetes-related complication (eg, ulcer) was unavailable, we used data from the hospital survey and other published studies [53][54] (Table 4).…”

Section: Costsmentioning

confidence: 99%

Cost-Effectiveness of Saxagliptin Versus Acarbose as Second-Line Therapy in Type 2 Diabetes in China

Shao

Zeng

et al. 2016

ObjectiveThis study assessed the long-term cost-effectiveness of saxagliptin+metformin (SAXA +MET) versus acarbose+metformin (ACAR+MET) in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on MET alone. MethodsSystematic literature reviews were performed to identify studies directly comparing SAXA +MET versus ACAR+MET, and to obtain diabetes-related events costs which were modified by hospital surveys. A Cardiff Diabetes Model was used to estimate the long-term economic and health treatment consequences in patients with T2DM. Costs (2014 Chinese yuan) were calculated from the payer's perspective and estimated over a patient's lifetime. ResultsSAXA+MET predicted lower incidences of most cardiovascular events, hypoglycemia events and fatal events, and decreased total costs compared with ACAR+MET. For an individual patient, the quality-adjusted life-years (QALYs) gained with SAXA+MET was 0.48 more than ACAR+MET at a cost saving of ¥18,736, which resulted in a cost saving of ¥38,640 per QALY gained for SAXA+MET versus ACAR+MET. Results were robust across various univariate and probabilistic sensitivity analyses. ConclusionSAXA+MET is a cost-effective treatment alternative compared with ACAR+MET for patients with T2DM in China, with a little QALYs gain and lower costs. SAXA is an effective, well-tolerated drug with a low incidence of adverse events and ease of administration; it is anticipated to be an effective second-line therapy for T2DM treatment.