Evaluating the cost‐effectiveness of reduced mild hypoglycaemia in subjects with Type 1 diabetes treated with insulin detemir or NPH insulin in Denmark, Sweden, Finland and the Netherlands

Valentine, William J.; Jendle, Johan; Saraheimo, Markku; Thorsteinsson, Birger; Pollock, Richard F; Lammert, Morten

doi:10.1111/j.1464-5491.2011.03461.x

Cited by 14 publications

(27 citation statements)

References 29 publications

(53 reference statements)

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“…However, the approximated values that are maintained from the original models [15,16] give conservative estimations of the NSH RR, as already discussed by Valentine et al in their paper [15], and offer the advantage of integrating data from a very controlled setting (RCTs [13,14]), with a setting that is closer to the "real world" data (observational study [18,19]), as explained by Ridderstrale et al [16].…”

Section: Discussionmentioning

confidence: 93%

“…On the other hand, short-term cost-effectiveness analyses for IDet vs. NPH are available for Scandinavian countries estimating ICERs in the range of €12,216 -€16,568/QALY (year 2010) for T1DM [15] and €21,768 -€28,349/QALY (year 2012) for T2DM [16] over a 1 year period.…”

Section: Discussionmentioning

confidence: 99%

“…This short-term cost-effectiveness analysis is based on previously published economical evaluations for Scandinavian countries [15,16] and relies on statistically significant efficacy differences between IDet and NPH.…”

Section: Discussionmentioning

confidence: 99%

“…The structure of the model is based on two Scandinavian studies: Valentine et al (T1DM) and Ridderstråle et al (T2DM) [15,16].…”

Section: Cost-effectiveness Model and Patientsmentioning

confidence: 99%

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Cost-effectiveness Analysis of Insulin Detemir Compared to Neutral Protamine Hagedorn (NPH) in Patients with Type 1 and Type 2 Diabetes Mellitus in Portugal

Cardoso¹,

Arellano²,

Prades³

et al. 2016

J Diabetes Metab

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Objectives: To estimate the short-term (1 year) cost-effectiveness of Insulin Detemir (IDet) compared with Neutral Protamine Hagedorn (NPH) insulin for Type 1 (T1DM) and Type 2 Diabetes Mellitus (T2DM) in Portugal. Methods:A short-term cost-effectiveness model was adapted to the Portuguese National Health System (NHS), to estimate the Incremental Cost-Effectiveness Ratio (ICER) of IDet vs. NPH in terms of euros per quality-adjusted life years (€/QALY) gained. Non-severe hypoglycemia (NSH) rate for both diabetes types, and weight change, only for T2DM, were the clinical benefit variables. Three scenarios were estimated in which NPH was assigned three different values corresponding to a cohort of recent insulinization and a cohort of long-run insulinization from the UK Hypoglycemia Study and from a Spanish observational study. For all scenarios, the hypoglycemia Rate Ratio (RR) for T1DM was based on the CADTH Technology Report while for T2DM it was based on the head-to-head NCT00104182 randomized clinical trial. For T2DM, weight gain was also included in the model, based on the same RCT. Disutility values to calculate quality-adjusted life years (QALYs) were associated to NSH events and to BMI unit gain. Costs (Euros 2014), estimated from the perspective of the Portuguese NHS, included only insulin treatment and mild hypoglycemia management. Results:For the three scenarios a range of 0.025 -0.076 QALYs for T1DM and 0.014 -0.051 QALYs for T2DM were gained for IDet vs. NPH due to NSH and weight gain avoidance, in return of an incremental cost of €159.38 -€248.98 for T1DM and €209.66 -€274.44 for T2DM. This resulted in IDet vs. NPH ICER ranging between €2,096.23 and €9,936.98/QALY for T1DM and €4,145.75 and €19,999.87/QALY for T2DM.Conclusions: IDet appears as a cost-effective alternative to NPH in Portugal for T1DM and T2DM in all considered scenarios due to lower hypoglycemic rate and less weight gain.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The structure of the model is based on two Scandinavian studies: Valentine et al (T1DM) and Ridderstråle et al (T2DM) [15,16].…”

Section: Cost-effectiveness Model and Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Cost-effectiveness Analysis of Insulin Detemir Compared to Neutral Protamine Hagedorn (NPH) in Patients with Type 1 and Type 2 Diabetes Mellitus in Portugal

Cardoso¹,

Arellano²,

Prades³

et al. 2016

J Diabetes Metab

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“…(15)(16)(17)(18)(19)(20) Three found that iDet was less costly and more effective; . (17)(18)(19) while the other two found that iDet was more costly and more effective. Similarly, conflicting results were found for the comparison of iNPH with iGlarg (16;20) None of these studies evaluated iDegl; none compared all basal insulin regimens and importantly, none have considered the frequency of daily injections of each insulin.…”

Section: Introductionmentioning

confidence: 99%

Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus: A Cost-Utility Analysis

et al. 2017

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ObjectivesTo assess the cost effectiveness of basal insulin regimens for adults with Type 1 diabetes (T1D) in England. MethodsCost-utility analysis (CUA) was undertaken in accordance with NICE reference case. UK NHS and personal and social services (PSS) perspective was used and 3.5% discount rate applied for both costs and outcomes. Relative effectiveness estimates were based on a systematic review of published trials and a Bayesian network meta-analysis (NMA). The IMS CORE Diabetes Model (CDM) was used, where net monetary benefit (NMB) was calculated using a threshold of £20,000 per quality-adjusted life-year (QALY) gained. Wide range of sensitivity analyses was undertaken. ResultsInsulin detemir (twice-daily) [iDet (bid)] had the highest mean QALY gain (11.09 QALYs) and NMB (£181,456) per patient over the model time horizon. Compared to the lowest cost strategy (insulin NPH once daily [iNPH (od)]; it had an incremental cost-effectiveness ratio (ICER) of £7,844 per QALY-gained. Insulin glargine (od) [iGlarg (od)] and iDet (od) were ranked as second and third, with NMB of £180,893 and £180,423, respectively. iDet (bid)] remained the most cost-effective treatment throughout the sensitivity analyses performed except when high doses were assumed (>30% increment compared to other regimens); where in this scenario analysis iGlarg (od) ranked first. ConclusionsiDet (bid) is the most cost-effective regimen; providing the highest QALY gain and NMB. iGlarg (od) and iDet (od) are possible options for those for whom the twice daily regimen of insulin determir is not acceptable or does not achieve required glycaemic control.

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Insulin Therapy for Type 2 Diabetes Mellitus

Wallia

Molitch

2014

JAMA

126

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Evaluating the cost‐effectiveness of reduced mild hypoglycaemia in subjects with Type 1 diabetes treated with insulin detemir or NPH insulin in Denmark, Sweden, Finland and the Netherlands

Abstract: Insulin detemir is likely to be cost-effective vs. NPH insulin in subjects with Type 1 diabetes in Denmark, Sweden, Finland and the Netherlands. Increased pharmacy costs with insulin detemir should not be a barrier to therapy based on these findings.

Cited by 14 publications

References 29 publications

Cost-effectiveness Analysis of Insulin Detemir Compared to Neutral Protamine Hagedorn (NPH) in Patients with Type 1 and Type 2 Diabetes Mellitus in Portugal

Cost-effectiveness Analysis of Insulin Detemir Compared to Neutral Protamine Hagedorn (NPH) in Patients with Type 1 and Type 2 Diabetes Mellitus in Portugal

Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus: A Cost-Utility Analysis

Insulin Therapy for Type 2 Diabetes Mellitus

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