Treatment Costs of Basal Insulin Regimens for Type 2 Diabetes Mellitus in France
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ORIGINAL RESEARCH ARTICLE
Treatment Costs of Basal Insulin Regimens for Type 2 Diabetes Mellitus in France Bruno Detournay1 · Zahra Boultif2 · Amar Bahloul2 · Viviane Jeanbat1 · Julien Robert1 Accepted: 21 October 2020 © The Author(s) 2020
Abstract Objective Our objectives were to describe the basal insulin treatment regimens most widely used in a real-world setting in France and to estimate the associated treatment costs in people with type 2 diabetes mellitus (T2DM). Methods A cross-sectional observational study was conducted (November 2017–February 2018) among adult patients with T2DM requiring basal insulin therapy for their own use in a representative sample of pharmacies. Costs were compared between patients treated with three recently marketed insulins (glargine 300 U/ml [Gla-300], biosimilar glargine 100 U/ml [Gla-100] and a fixed-ratio combination of insulin degludec and liraglutide) and those treated with three established basal or intermediate insulins: branded glargine 100 U/ml, insulin detemir and neutral protamine Hagedorn insulin [NPH]). Results Overall, 1933 patients were analysed. Gla-300 accounted for 59.9% of novel basal insulin prescriptions, and branded Gla-100 accounted for 67.9% of established insulin prescriptions. Recent insulins were more frequently associated with glucagon-like peptide-1 (GLP-1) analogues. Results confirmed a lower rate of severe hypoglycaemia with Gla-300 than with Gla-100. On average, weekly total costs of treatment with all basal insulins were not significantly different, except with detemir, where they were higher. Conclusion New basal insulins are expected to be integrated into clinical practice. This analysis shows that their use does not impact upon the management cost of insulin therapy in people with T2DM.
1 Introduction Insulin therapy is essential to the treatment of type 1 diabetes mellitus (T1DM) and is also important in type 2 diabetes mellitus (T2DM) to achieve glycaemic targets in people Electronic supplementary material The online version of this article (https://doi.org/10.1007/s41669-020-00237-4) contains supplementary material, which is available to authorized users. * Bruno Detournay [email protected] Zahra Boultif [email protected] Amar Bahloul [email protected] Viviane Jeanbat [email protected] Julien Robert [email protected] 1
CEMKA-EVAL, 43, boulevard Maréchal Joffre, 92340 Bourg‑la‑Reine, France
Sanofi, 94250 Gentilly, France
2
who do not achieve adequate glycaemic control with oral antidiabetic drugs (OADs). Over the last two decades, the place of insulin therapy in T2DM has increased as awareness has grown about the benefits of an early switch from OADs to insulin to improve long-term outcomes. A prescription survey of insulin use in patients with T2DM performed in France in 2015 reported that 24% were prescribed insulin therapy [1]. Current international [2] and French [3] practice guidelines recommend using injectable therapy (insulin or glucagon-like peptide-1 [GLP-1] receptor agonists)
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