IMS Health, Seoul, South Korea.
Value Health. 2009 Nov-Dec;12 Suppl 3:S55-61. doi: 10.1111/j.1524-4733.2009.00628.x.
To estimate the cost-effectiveness of switching patients with poorly controlled type 2 diabetes mellitus from human insulin (HI) to biphasic insulin aspart 30 (BIAsp 30) in South Korea.
A published and validated diabetes computer simulation model (the IMS CORE Diabetes Model) was used to evaluate the long-term clinical and economic outcomes associated with switching to BIAsp 30, using treatment effects from the South Korean subgroup of the Physician's Routine Evaluation of Safety and Efficacy of NovoMix 30 Therapy study and cost data collected through primary research. Outcomes included life expectancy, quality-adjusted life expectancy, incidence of complications, direct medical costs, and cost-effectiveness. Analyses were performed from a third-party payer perspective over a 30-year time horizon. Future costs and clinical benefits were discounted at 5% per annum. Extensive sensitivity analyses were performed.
Switching patients uncontrolled on HI to BIAsp 30 was projected to increase discounted mean life expectancy by 0.15 +/- 0.18 years per patient (8.62 +/- 0.13 years vs. 8.47 +/- 0.13 years) and improve discounted mean quality-adjusted life expectancy by 0.30 +/- 0.12 quality-adjusted life-years (QALYs) per patient (5.68 +/- 0.09 QALYs vs. 5.38 +/- 0.09 QALYs). Conversion to BIAsp 30 was associated with a mean increase in direct costs of South Korean Won (KRW) 1,777,323 +/- 359,209 over patient lifetimes. BIAsp 30 was associated with an incremental cost-effectiveness ratio of KRW5,916,758 per QALY gained versus HI.
Switching patients uncontrolled on HI to BIAsp 30 was projected to improve life expectancy and quality-adjusted life expectancy. This analysis suggests that BIAsp 30 could be a cost-effective treatment option in type 2 diabetes patients poorly controlled on HI in South Korea.
评估将韩国 2 型糖尿病控制不佳的患者从人胰岛素（HI）切换为双相门冬胰岛素 30（BIAsp 30）的成本效益。
使用经过验证的已发表糖尿病计算机模拟模型（IMS CORE Diabetes Model），根据韩国医生常规评估诺和锐 30 治疗安全性和疗效研究的亚组治疗效果和通过初步研究收集的成本数据，评估切换至 BIAsp 30 的长期临床和经济结局。结局包括预期寿命、质量调整预期寿命、并发症发生率、直接医疗成本和成本效益。分析从第三方支付者的角度在 30 年的时间范围内进行。未来的成本和临床效益以每年 5%的贴现率进行贴现。进行了广泛的敏感性分析。
将 HI 控制不佳的患者切换至 BIAsp 30 预计会使每位患者的贴现平均预期寿命增加 0.15 年（8.62 年），质量调整后的预期寿命增加 0.30 年（5.68 年）。将患者转换为 BIAsp 30 会导致每位患者的直接成本增加 1777323 韩元（KRW），359209 韩元。与 HI 相比，BIAsp 30 每获得一个质量调整生命年（QALY）的增量成本效益比为 5916758 KRW。
将 HI 控制不佳的患者切换至 BIAsp 30 可提高预期寿命和质量调整后的预期寿命。这项分析表明，在韩国 HI 控制不佳的 2 型糖尿病患者中，BIAsp 30 可能是一种具有成本效益的治疗选择。
