(Ultra-)long-acting insulin analogues for people with type 1 diabetes mellitus

Hemmingsen, Bianca; Metzendorf, Maria‐Inti; Richter, Bernd

doi:10.1002/14651858.cd013498.pub2

Cited by 21 publications

(10 citation statements)

References 92 publications

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“…Long-acting insulin analogues were specifically developed to lower the risk of hypoglycaemia in patients with diabetes requiring insulin, especially nocturnal hypoglycaemia, as well as improve patient convenience through reducing the number of injections thereby enhancing adherence rates, which is a continuing concern with insulin [7,9,[27][28][29][30]. There is still controversy though regarding the level of benefit seen with long-acting insulin analogues versus NPH and other insulins [31][32][33]. However, a recent systematic review and network meta-analysis suggests that long-acting insulin analogues were superior to intermediate-acting insulins in key areas including major, serious, and nocturnal hypoglycaemia [34].…”

Section: Introductionmentioning

confidence: 99%

Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications

Godman

Władysiuk

McTaggart

et al. 2021

BioMed Research International

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Background. Diabetes mellitus rates and associated costs continue to rise across Europe enhancing health authority focus on its management. The risk of complications is enhanced by poor glycaemic control, with long-acting insulin analogues developed to reduce hypoglycaemia and improve patient convenience. There are concerns though with their considerably higher costs, but moderated by reductions in complications and associated costs. Biosimilars can help further reduce costs. However, to date, price reductions for biosimilar insulin glargine appear limited. In addition, the originator company has switched promotional efforts to more concentrated patented formulations to reduce the impact of biosimilars. There are also concerns with different devices between the manufacturers. As a result, there is a need to assess current utilisation rates for insulins, especially long-acting insulin analogues and biosimilars, and the rationale for patterns seen, among multiple European countries to provide future direction. Methodology. Health authority databases are examined to assess utilisation and expenditure patterns for insulins, including biosimilar insulin glargine. Explanations for patterns seen were provided by senior-level personnel. Results. Typically increasing use of long-acting insulin analogues across Europe including both Western and Central and Eastern European countries reflects perceived patient benefits despite higher prices. However, activities by the originator company to switch patients to more concentrated insulin glargine coupled with lowering prices towards biosimilars have limited biosimilar uptake, with biosimilars not currently launched in a minority of European countries. A number of activities were identified to address this. Enhancing the attractiveness of the biosimilar insulin market is essential to encourage other biosimilar manufacturers to enter the market as more long-acting insulin analogues lose their patents to benefit all key stakeholder groups. Conclusions. There are concerns with the availability and use of insulin glargine biosimilars among European countries despite lower costs. This can be addressed.

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Section: Introductionmentioning

confidence: 99%

Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications

Godman

Władysiuk

McTaggart

et al. 2021

BioMed Research International

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“…The 2021 ADA/ EASD guidelines make no distinction between human and analogue insulin [9]. The WHO added long-acting analogues to its Essential Medicines List in its 2021 revision, counter to evidence it had previously found convincing [10,11]. Some people undoubtedly benefit from their use, but across-theboard advantage in terms of glycaemic control has yet to be demonstrated [12].…”

Section: The 'New Insulins' Are Modified Delivery Systemsmentioning

confidence: 99%

The insulin market reaches 100

2022

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“…Long-acting insulin analogues were developed to reduce the risk of hypoglycaemia, especially nocturnal hypoglycaemia, producing greater patient convenience through reducing the number of injections (Pedersen-Bjergaard et al, 2014;Rys et al, 2015;Godman et al, 2021a;Chan et al, 2021;Tricco et al, 2021). Whilst there have been concerns over their additional costs versus standard insulins such as NPH insulins, and whether this represents value (Caires de Souza et al, 2014;Almeida et al, 2018;Ewen et al, 2019;Hemmingsen et al, 2021), recent published studies, including systematic reviews, have shown that their higher acquisition costs can be offset by savings from averted costs associated with hypoglycaemia and other complications (Jendle et al, 2020;Lee et al, 2020;Shafie and Ng, 2020;Tricco et al, 2021) generating medium to long-term savings. As a result, long-acting insulin analogues are now the most widely prescribed insulins among high-income and high middle-income countries, with sales growing in other countries including Central and Eastern European (CEE) countries as well as Bangladesh and India (Silver et al, 2018;Ewen et al, 2019;Godman et al, 2021a;Haque et al, 2021a;Godman et al, 2021c;Godman et al, 2021d).…”

Section: Introductionmentioning

confidence: 99%

Enhancing Choices Regarding the Administration of Insulin Among Patients With Diabetes Requiring Insulin Across Countries and Implications for Future Care

et al. 2022

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There are a number of ongoing developments to improve the care of patients with diabetes across countries given its growing burden. Recent developments include new oral medicines to reduce cardiovascular events and death. They also include new modes to improve insulin administration to enhance adherence and subsequent patient management thereby reducing hypoglycaemia and improving long-term outcomes. In the case of insulins, this includes long-acting insulin analogues as well as continuous glucose monitoring (CGM) systems and continuous subcutaneous insulin infusion systems, combined with sensor-augmented pump therapy and potentially hybrid closed-loops. The benefits of such systems have been endorsed by endocrine societies and governments in patients with Type 1 diabetes whose HbA1c levels are not currently being optimised. However, there are concerns with the low use of such systems across higher-income countries, exacerbated by their higher costs, despite studies suggesting their cost-effectiveness ratios are within accepted limits. This is inconsistent in higher-income countries when compared with reimbursement and funding decisions for new high-priced medicines for cancer and orphan diseases, with often limited benefits, given the burden of multiple daily insulin injections coupled with the need for constant monitoring. This situation is different among patients and governments in low- and low-middle income countries struggling to fund standard insulins and the routine monitoring of HbA1c levels. The first priority in these countries is to address these priority issues before funding more expensive forms of insulin and associated devices. Greater patient involvement in treatment decisions, transparency in decision making, and evidence-based investment decisions should help to address such concerns in the future.

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(Ultra-)long-acting insulin analogues for people with type 1 diabetes mellitus

Cited by 21 publications

References 92 publications

Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications

Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications

The insulin market reaches 100

Enhancing Choices Regarding the Administration of Insulin Among Patients With Diabetes Requiring Insulin Across Countries and Implications for Future Care

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