Economic evaluation of the treatment of type 2 diabetes with insulin glargine based on the LAPTOP trial.

In the LAPTOP trial, combination therapy with once-daily insulin glargine + oral antidiabetic agents glimepiride and metformin (BOT) was compared to twice-daily premixed insulin (CT). BOT was safer and more effective than CT. Cost analysis of both regimens were compared over a 1-year period. Analyses were performed from the perspective of the German statutory health insurance. Costs per patient per year were on average 236euro lower for BOT than for CT therapy. Economic advantage for BOT was robust to variation of expenses within a range of at least +/-20%. Insulin utilisation and prices were the major cost drivers, followed by costs associated with monitoring of blood glucose levels. Cost analysis of the LAPTOP trial suggest that BOT is more cost effective alternative to CT.