Leelarathna Lalantha, Ashley Donna, Fidler Carrie, Parekh Witesh
Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Novo Nordisk Ltd, Gatwick, UK.
Ther Adv Endocrinol Metab. 2018 Jul;9(7):187-197. doi: 10.1177/2042018818766816. Epub 2018 Apr 4.
Fast-acting insulin aspart is a new formulation of the rapid-acting insulin analogue insulin aspart and represents an advancement over current rapid-acting insulin analogues in terms of onset of action and postprandial glucose control. The objective of the current analysis was to demonstrate the cost impact of prescribing fast-acting insulin aspart instead of insulin aspart, to highlight the value of fast-acting insulin aspart for the treatment of people with diabetes requiring mealtime insulin.
A cost-impact analysis was conducted from the perspective of the UK National Health Service (NHS). The analysis excluded patients' out-of-pocket expenses, carers' costs and lost productivity. The time horizon of the analysis was 1 year, and no discounting was therefore applied.
The displacement of insulin aspart with fast-acting insulin aspart is cost neutral for the UK NHS. Fast-acting insulin aspart is at price parity to insulin aspart in terms of the vial and Penfill cartridge and is available in the FlexTouch pen at the same price as the insulin aspart FlexPen (and thus cheaper than the insulin aspart FlexTouch pen). Patients using the insulin aspart FlexPen will be upgraded to the FlexTouch pen device, which is preferred by patients and healthcare professionals, on switching to fast-acting insulin aspart, at no additional cost.
Fast-acting insulin aspart offers additional clinical benefit but at no additional cost when compared with insulin aspart, and thus provides value to the UK NHS.
门冬胰岛素速锐是速效胰岛素类似物门冬胰岛素的一种新剂型,在起效时间和餐后血糖控制方面比现有的速效胰岛素类似物有所进步。本分析的目的是证明处方使用门冬胰岛素速锐而非门冬胰岛素的成本影响,以突出门冬胰岛素速锐对于需要餐时胰岛素治疗的糖尿病患者的价值。
从英国国家医疗服务体系(NHS)的角度进行成本影响分析。该分析排除了患者的自付费用、护理人员成本和生产力损失。分析的时间范围为1年,因此未应用贴现。
用门冬胰岛素速锐替代门冬胰岛素对英国NHS而言成本无变化。就小瓶和笔芯装而言,门冬胰岛素速锐与门冬胰岛素价格相当,且其在FlexTouch笔中的售价与门冬胰岛素FlexPen相同(因此比门冬胰岛素FlexTouch笔便宜)。使用门冬胰岛素FlexPen的患者在改用门冬胰岛素速锐时将升级到FlexTouch笔装置,该装置更受患者和医护人员青睐,且无需额外费用。
与门冬胰岛素相比,门冬胰岛素速锐可提供额外的临床益处且无需额外成本,因此对英国NHS具有价值。