Cost-Effectiveness of Insulin Degludec Versus Insulin Glargine U300 in the Netherlands: Evidence From a Randomised Contr
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ORIGINAL RESEARCH
Cost-Effectiveness of Insulin Degludec Versus Insulin Glargine U300 in the Netherlands: Evidence From a Randomised Controlled Trial Marc Evans . Robert G. J. Moes . Katrine S. Pedersen . Jens Gundgaard . Thomas R. Pieber
Received: February 28, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: This study aimed to evaluate the short-term cost-effectiveness of insulin degludec 200 units/mL (degludec) versus insulin glargine 300 units/mL (glargine U300) from a Dutch societal perspective. Methods: A previously published model estimated costs [2018 euros (EUR)] and effectiveness [quality-adjusted life years (QALYs)] with degludec compared with glargine U300 over a Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12046512. Electronic Supplementary Material The online version of this article (https://doi.org/10.1007/s12325020-01332-y) contains supplementary material, which is available to authorized users. M. Evans (&) University Hospital Llandough, Penarth, UK e-mail: [email protected] R. G. J. Moes Novo Nordisk B.V., Alphen aan den Rijn, Netherlands K. S. Pedersen Novo Nordisk Region Europe, Copenhagen, Denmark J. Gundgaard Novo Nordisk A/S, Søborg, Denmark T. R. Pieber Department of Internal Medicine, Medical University of Graz, Graz, Austria
1-year time horizon. The model captured hypoglycaemia rates and insulin dosing. Clinical outcomes were informed by CONCLUDE (NCT03078478), a head-to-head randomised controlled trial in insulin-experienced patients with type 2 diabetes. Results: Treatment with degludec was associated with mean annual cost savings (EUR 24.71 per patient) relative to glargine U300, driven by a lower basal insulin dose and lower severe hypoglycaemia rate with degludec compared with glargine U300. Lower rates of non-severe nocturnal and severe hypoglycaemia resulted in improved effectiveness (? 0.0045 QALYs) with degludec relative to glargine U300. In sensitivity analyses, changes to the vast majority of model parameters did not materially affect model outcomes. Conclusions: This short-term analysis, informed by the latest clinical trial evidence, demonstrated that degludec was a cost-effective treatment option relative to glargine U300. As such, our modelling analysis suggests that degludec would represent an efficient use of Dutch public healthcare resources in this patient population. Keywords: Diabetes; Health technology assessment; Hypoglycaemia; Insulin analogue; Insulin therapy; Pharmaco-economics
Adv Ther
Key Summary Points Why carry out this study? As the societal burden of chronic diseases continues to rise, economic decision modelling tools are increasingly used to support healthcare decision-making. As cost-effectiveness is a relative concept, one of the most important structural modelling choices is selection of the most appropriate comparator to ensure that results are relevant and applicable to healthcare decisions. Here, we evaluated the short-term costeffectiveness of two long-acting basal insulins, deglud
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