Lalić Nebojša, Russel-Szymczyk Monika, Culic Marina, Tikkanen Christian Klyver, Chubb Barrie
Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia.
Novo Nordisk Pharma Sp. z o.o., Warsaw, Poland.
Diabetes Ther. 2018 Jun;9(3):1201-1216. doi: 10.1007/s13300-018-0426-0. Epub 2018 Apr 26.
This study investigates the cost-effectiveness of insulin degludec versus insulin glargine U100 in patients with type 1 and type 2 diabetes mellitus in Serbia.
A cost-utility analysis, implementing a simple short-term model, was used to compare treatment costs and outcomes with degludec versus glargine U100 in patients with type 1 (T1DM) and type 2 diabetes (T2DM). Cost-effectiveness was analysed in a 1-year setting, based on data from clinical trials. Costs were estimated from the healthcare payer perspective, the Serbian Health Insurance Fund (RFZO). The outcome measure was the incremental cost-effectiveness ratio (ICER) or cost per quality-adjusted life-year (QALY) gained.
Degludec is highly cost-effective compared with glargine U100 for people with T1DM and T2DM in Serbia. The ICERs are estimated at 417,586 RSD/QALY gained in T1DM, 558,811 RSD/QALY gained in T2DM on basal oral therapy (T2DM) and 1,200,141 RSD/QALY gained in T2DM on basal-bolus therapy (T2DM). All ICERs fall below the commonly accepted thresholds for cost-effectiveness in Serbia (1,785,642 RSD/QALY gained). In all three patient groups, insulin costs are higher with degludec than with glargine U100, but these costs are partially offset by savings from a lower daily insulin dose in T1DM and T2DM, a reduction in hypoglycaemic events in all three patient groups and reduced costs of SMBG testing in the T2DM groups with degludec versus glargine U100.
Degludec is a cost-effective alternative to glargine U100 for patients with T1DM and T2DM in Serbia. Degludec may particularly benefit those suffering from hypoglycaemia or where the patient would benefit from the option of flexible dosing.
Novo Nordisk.
本研究调查了在塞尔维亚，德谷胰岛素与甘精胰岛素U100相比，用于1型和2型糖尿病患者的成本效益。
采用成本效用分析，运用一个简单的短期模型，比较德谷胰岛素与甘精胰岛素U100在1型糖尿病（T1DM）和2型糖尿病（T2DM）患者中的治疗成本和结果。基于临床试验数据，在1年的时间范围内分析成本效益。从医疗保健支付方，即塞尔维亚健康保险基金（RFZO）的角度估算成本。结果指标是增量成本效益比（ICER）或每获得一个质量调整生命年（QALY）的成本。
在塞尔维亚，对于T1DM和T2DM患者，德谷胰岛素与甘精胰岛素U100相比具有很高的成本效益。T1DM中每获得一个QALY的ICER估计为417,586塞尔维亚第纳尔，基础口服治疗的T2DM中为558,811塞尔维亚第纳尔，基础-餐时治疗的T2DM中为1,200,141塞尔维亚第纳尔。所有ICER均低于塞尔维亚普遍接受的成本效益阈值（每获得一个QALY为1,785,642塞尔维亚第纳尔）。在所有三个患者组中，德谷胰岛素的胰岛素成本高于甘精胰岛素U100，但这些成本在一定程度上被T1DM和T2DM中每日胰岛素剂量降低、所有三个患者组中低血糖事件减少以及德谷胰岛素与甘精胰岛素U100相比T2DM组自我血糖监测测试成本降低所节省的费用所抵消。
在塞尔维亚，对于T1DM和T2DM患者，德谷胰岛素是甘精胰岛素U100具有成本效益的替代方案。德谷胰岛素可能对低血糖患者或能从灵活给药选项中获益的患者特别有益。
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