Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy.
Sanofi S.p.A, Milan, Italy.
Nutr Metab Cardiovasc Dis. 2020 Oct 30;30(11):1937-1944. doi: 10.1016/j.numecd.2020.07.005. Epub 2020 Jul 8.
To evaluate the economic impact of using 2nd generation basal insulin analogs, Glargine 300 Units/ml (Gla-300) vs Degludec 100 Units/ml (IDeg-100), in patients with type 2 diabetes (T2D).
An economic analysis was conducted using findings from the BRIGHT study (the first controlled, head-to-head study comparing Gla-300 vs IDeg-100), and costs for the Italian National Healthcare Service (NHS). A cost-minimization analysis (CMA) and a budget impact analysis (BIA) were conducted. Only pharmacological costs were included in the analysis. The CMA estimated patient treatment costs at 24 weeks and 1 year; the BIA assessed the economic impact of treating the overall Italian population of T2D insulin-naïve patients, who initiated insulin treatment during the period September 2017-August 2018 (N = 55 318). In the BIA, four different scenarios were compared: i) all patients receive IDeg-100 (Scenario A); ii) 61% of patients receive Gla-300, 39% IDeg-100 (Scenario B); iii) 80% of patients receive Gla-300, 20% IDeg-100 (Scenario C); iv) all patients treated with Gla-300 (Scenario D). The average treatment costs per patient were lower with Gla-300 vs IDeg-100 (at 24 weeks: €129 vs €161; at 1 year: €324 vs €409, respectively). Results of the BIA showed that comparing Scenario D vs Scenario A, total savings would amount to €1.76 million at 24 weeks, €4.73 million at 1 year, €5.53 million at 2 years.
A larger use of Gla-300 vs IDeg-100 for the treatment of T2D patients would lead to a relevant reduction of therapy costs in Italy.
评估在 2 型糖尿病（T2D）患者中使用第二代基础胰岛素类似物，甘精胰岛素 300 单位/毫升（Gla-300）与地特胰岛素 100 单位/毫升（IDeg-100）的经济影响。
使用 BRIGHT 研究（首次比较 Gla-300 与 IDeg-100 的对照、头对头研究）的研究结果和意大利国家医疗保健服务（NHS）的成本进行了经济分析。进行了成本最小化分析（CMA）和预算影响分析（BIA）。仅纳入分析药物经济学成本。CMA 估计 24 周和 1 年的患者治疗成本；BIA 评估了在 2017 年 9 月至 2018 年 8 月期间开始胰岛素治疗的所有 T2D 胰岛素初治患者的意大利总体人群的经济影响（N=55318）。在 BIA 中，比较了以下四个不同方案：i）所有患者均接受 IDeg-100（方案 A）；ii）61%的患者接受 Gla-300，39%接受 IDeg-100（方案 B）；iii）80%的患者接受 Gla-300，20%接受 IDeg-100（方案 C）；iv）所有患者均接受 Gla-300（方案 D）。与 IDeg-100 相比，Gla-300 的每位患者平均治疗成本更低（24 周：€129 对 €161；1 年：€324 对 €409）。BIA 的结果表明，与方案 A 相比，方案 D 在 24 周时总成本节省 176 万欧元，1 年时节省 4730 万欧元，2 年时节省 5530 万欧元。
在治疗 T2D 患者时，更多地使用 Gla-300 而不是 IDeg-100 将导致意大利治疗成本的显著降低。
