Schöffski Oliver, Breitscheidel Lusine, Benter Ursula, Dippel Franz-Werner, Müller Markus, Volk Michael, Pfohl Martin
Universität Erlangen-Nürnberg, Nürnberg, Germany.
J Med Econ. 2008;11(4):695-712. doi: 10.3111/13696990802645726.
To assess and compare the total costs relevant to diabetes care in patients with type 2 diabetes mellitus (T2D) treated at specialised diabetes practices with either insulin glargine- or conventional basal insulin (neutral protamine Hagedorn [NPH])-based therapies from the German statutory health insurance (SHI) perspective.
The Long Acting Insulin Glargine Versus NPH Cost Evaluation in Specialised Practices (LIVE-SPP) study is an observational, retrolective, multicentre longitudinal cost comparison in adults with T2D. Costs were evaluated from the German SHI perspective based on official 2005 prices. Average total costs per patient for insulin glargine-versus NPH-based therapies were compared using multivariate general linear modelling. Sensitivity analyses were performed by varying the main cost factors by +/- 25%.
Patients (n=1,024, 512 patients per cohort) were on average 62 years of age, with an average 8-year diabetes history at study start. The average unadjusted total annual costs per patient were euro 1,868.41 (95% CI 1,744.27-1,992.56) for insulin glargine-based vs. euro 2,063.72 (95% CI 1,922.91-2,204.54) for NPH-based therapies. Average adjusted total annual costs per patient between insulin glargine- (euro 1,241.13) and NPH-based therapies (euro 1,607.86) were statistically significantly different (p=0.0004). The economic advantage for insulin glargine-based therapies resulted mainly from fewer blood glucose measurements and other diabetes-related materials (e.g. needles). The savings remained stable in one-way sensitivity analyses.
The LIVE-SPP study suggests that insulin glargine-based therapies may offer an economic advantage over NPH-based therapies.
从德国法定医疗保险(SHI)的角度,评估并比较在专科糖尿病诊所接受治疗的2型糖尿病(T2D)患者中,使用甘精胰岛素或传统基础胰岛素(中性鱼精蛋白锌胰岛素[NPH])治疗方案所涉及的糖尿病护理总成本。
专科诊所中甘精胰岛素与NPH成本评估(LIVE-SPP)研究是一项针对成年T2D患者的观察性、回顾性、多中心纵向成本比较研究。成本从德国SHI的角度,依据2005年官方价格进行评估。使用多变量一般线性模型比较甘精胰岛素与NPH治疗方案每位患者的平均总成本。通过将主要成本因素上下浮动25%进行敏感性分析。
患者(n = 1,024,每组队列512例患者)平均年龄62岁,研究开始时平均糖尿病病史8年。基于甘精胰岛素的治疗方案每位患者每年平均未调整总成本为1,868.41欧元(95%置信区间1,744.27 - 1,992.56),而基于NPH的治疗方案为2,063.72欧元(95%置信区间1,922.91 - 2,204.54)。基于甘精胰岛素(1,241.13欧元)和基于NPH的治疗方案(1,607.86欧元)之间每位患者每年平均调整总成本在统计学上有显著差异(p = 0.0004)。基于甘精胰岛素的治疗方案的经济优势主要源于血糖测量次数减少以及其他糖尿病相关材料(如针头)的使用减少。在单向敏感性分析中,节省的费用保持稳定。
LIVE-SPP研究表明,基于甘精胰岛素的治疗方案可能比基于NPH的治疗方案具有经济优势。