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在意大利,基于 BRIGHT 研究的 2 型糖尿病二线基础胰岛素的成本效益分析。

Using 2nd generation basal insulins in type 2 diabetes: Costs and savings in a comparative economic analysis in Italy, based on the BRIGHT study.

机构信息

Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy.

Sanofi S.p.A, Milan, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2020 Oct 30;30(11):1937-1944. doi: 10.1016/j.numecd.2020.07.005. Epub 2020 Jul 8.

Abstract

BACKGROUND AND AIMS

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).

METHODS AND RESULTS

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.

CONCLUSION

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.

摘要

背景与目的

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。

方法和结果

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。

结论

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。

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