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基于 APOLLO 试验的甘精胰岛素治疗,比较德国血糖控制不佳的 2 型糖尿病的治疗费用。

Comparison of treatment costs in inadequately controlled type 2 diabetes in Germany based on the APOLLO trial with insulin glargine.

机构信息

Medizinische Klinik und Poliklinik III, Justus-Liebig Universität, Giessen, Germany.

出版信息

J Med Econ. 2009 Jun;12(2):87-97. doi: 10.3111/13696990902949614.

Abstract

OBJECTIVE

A cost analysis of once-daily insulin glargine versus three-times daily insulin lispro in combination with oral antidiabetic drugs (OADs) for insulin-naive type 2 diabetes patients in Germany based on the APOLLO trial (A Parallel design comparing an Oral antidiabetic drug combination therapy with either Lantus once daily or Lispro at mealtime in type 2 diabetes patients failing Oral treatment).

METHODS

Annual direct treatment costs were estimated from the perspective of the German statutory health insurance (SHI). Costs accounted for included insulin medication, disposable pens and consumable items (needles, blood glucose test strips and lancets). Sensitivity analyses (on resource use and unit costs) were performed to reflect current German practice.

RESULTS

Average treatment costs per patient per year in the base case were 1,073 euro for glargine and 1,794 euro for lispro. Insulin costs represented 65% vs. 37% of total costs respectively. Acquisition costs of glargine were offset by the lower costs of consumable items (380 euro vs. 1,139 euro). Sensitivity analyses confirmed the robustness of the results in favour of glargine. All scenarios yielded cost savings in total treatment costs ranging from 84 euro to 727 euro.

CONCLUSIONS

Combination therapy of once-daily insulin glargine versus three-times daily insulin lispro both with OADs, in the management of insulin-dependent type 2 diabetes offers the potential for substantial cost savings from the German SHI perspective.

摘要

目的

基于 APOLLO 试验(一项平行设计,比较每日一次甘精胰岛素与餐时三次赖脯胰岛素联合口服降糖药治疗口服降糖药治疗失败的 2 型糖尿病患者的疗效),对德国胰岛素初治 2 型糖尿病患者,分析每日一次甘精胰岛素与每日三次赖脯胰岛素分别联合口服降糖药的成本。

方法

从德国法定健康保险(SHI)角度评估了年度直接治疗成本。包括胰岛素药物、一次性笔和耗材(针、血糖测试条和采血针)的费用。进行了敏感性分析(资源利用和单位成本),以反映当前德国的实践情况。

结果

基础病例中,每位患者每年的平均治疗费用分别为甘精胰岛素 1073 欧元和赖脯胰岛素 1794 欧元。胰岛素费用分别占总成本的 65%和 37%。甘精胰岛素的购买成本被耗材成本较低(380 欧元对 1139 欧元)所抵消。敏感性分析证实了甘精胰岛素的结果具有稳健性。所有方案均使总治疗费用节省 84 至 727 欧元。

结论

在管理胰岛素依赖型 2 型糖尿病方面,每日一次甘精胰岛素联合口服降糖药与每日三次赖脯胰岛素联合口服降糖药的联合治疗,从德国 SHI 的角度来看,具有降低成本的潜力。

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