Psota Marek, Psenkova Maria Bucek, Racekova Natalia, Ramirez de Arellano Antonio, Vandebrouck Tom, Hunt Barnaby
Pharm-In, Ltd.
Novo Nordisk Ltd., Bratislava, Slovakia.
Clinicoecon Outcomes Res. 2017 Dec 12;9:749-762. doi: 10.2147/CEOR.S143127. eCollection 2017.
To investigate the cost-effectiveness of once-daily insulin degludec/liraglutide (IDegLira) versus basal-bolus therapy in patients with type 2 diabetes not meeting glycemic targets on basal insulin from a healthcare payer perspective in Slovakia.
Long-term clinical and economic outcomes for patients receiving IDegLira and basal-bolus therapy were estimated using the IMS CORE Diabetes Model based on a published pooled analysis of patient-level data.
IDegLira was associated with an improvement in quality-adjusted life expectancy of 0.29 quality-adjusted life years (QALYs) compared with basal-bolus therapy. The average lifetime cost per patient in the IDegLira arm was EUR 2,449 higher than in the basal-bolus therapy arm. Increased treatment costs with IDegLira were partially offset by cost savings from avoided diabetes-related complications. IDegLira was highly cost-effective versus basal-bolus therapy with an incremental cost-effectiveness ratio of EUR 8,590 per QALY gained, which is well below the cost-effectiveness threshold set by the law in Slovakia.
IDegLira is cost-effective in Slovakia, providing a simple option for intensification of basal insulin therapy without increasing the risk of hypoglycemia or weight gain and with fewer daily injections than a basal-bolus regimen.
从斯洛伐克医疗支付方的角度，研究每日一次的德谷胰岛素/利拉鲁肽（IDegLira）与基础-餐时胰岛素治疗方案相比，在接受基础胰岛素治疗但血糖未达标的2型糖尿病患者中的成本效益。
基于已发表的患者水平数据汇总分析，使用IMS CORE糖尿病模型估计接受IDegLira和基础-餐时胰岛素治疗患者的长期临床和经济结局。
与基础-餐时胰岛素治疗相比，IDegLira可使质量调整预期寿命提高0.29个质量调整生命年（QALY）。IDegLira组每位患者的平均终身成本比基础-餐时胰岛素治疗组高2449欧元。IDegLira增加的治疗成本部分被避免糖尿病相关并发症节省的成本所抵消。与基础-餐时胰岛素治疗相比，IDegLira具有很高的成本效益，增量成本效益比为每获得1个QALY 8590欧元，远低于斯洛伐克法律设定的成本效益阈值。
在斯洛伐克，IDegLira具有成本效益，为强化基础胰岛素治疗提供了一个简单的选择，既不会增加低血糖或体重增加的风险，且每日注射次数比基础-餐时胰岛素治疗方案少。
