Evans Marc, Morgan Angharad R, Bain Stephen C
Diabetes Resource Centre, University Hospital Llandough, Cardiff, UK.
Health Economics and Outcomes Research Ltd., Cardiff, UK.
Diabetes Ther. 2021 Jun;12(6):1593-1604. doi: 10.1007/s13300-021-01061-7. Epub 2021 Apr 26.
Type 2 diabetes mellitus is a chronic, progressive disease that frequently necessitates treatment with basal insulin to maintain adequate glycaemic control. In considering the value of different basal insulin therapies, although acquisition costs are of increasing importance to budget-constrained healthcare systems, value beyond simple price considerations should be taken into account. Whilst human basal insulins are of lower acquisition cost compared to long-acting insulin analogues, this difference in price has the potential to be offset in terms of total healthcare system value through the ultra-long duration of action and low variability in glucose-lowering activity which have been translated into real clinical benefits, in particular a reduced risk of hypoglycaemic events. The maintenance of glycaemic targets and avoidance of hypoglycaemia that have been associated with insulin analogues represent a significant value consideration, beyond price, for the use of basal insulin analogues to manage type 2 diabetes mellitus from the perspective of all stakeholders within the healthcare system, including payers, healthcare professionals, patients and society.
2型糖尿病是一种慢性、进行性疾病，常常需要使用基础胰岛素进行治疗，以维持血糖的充分控制。在考量不同基础胰岛素疗法的价值时，尽管获取成本对于预算紧张的医疗系统愈发重要，但除了简单的价格因素外，还应考虑其他价值因素。虽然与长效胰岛素类似物相比，人基础胰岛素的获取成本较低，但通过超长效的作用时间和降糖活性的低变异性，在医疗系统的总体价值方面，这种价格差异有可能被抵消，而这些特性已转化为实际的临床益处，特别是降低了低血糖事件的风险。从医疗系统内所有利益相关者（包括支付方、医疗专业人员、患者和社会）的角度来看，维持血糖目标以及避免与胰岛素类似物相关的低血糖，对于使用基础胰岛素类似物来管理2型糖尿病而言，是一个超出价格的重要价值考量因素。
