West China School of Pharmacy, Sichuan University, Chengdu, China.
Front Public Health. 2022 Oct 18;10:1016937. doi: 10.3389/fpubh.2022.1016937. eCollection 2022.
To evaluate the long-term cost effectiveness of insulin degludec/insulin aspart (IDegAsp) vs. biphasic insulin aspart 30 (BIAsp 30) for the treatment of people with type 2 diabetes mellitus (T2DM) inadequately managed on basal insulin in China.
The CORE (the Center for Outcomes Research) Diabetes Model, which has been published and verified, was used to simulate disease progression and calculate the total direct medical costs, life years (LYs) and quality-adjusted life years (QALYs) over 30 years, from the perspective of Chinese healthcare system. The patient demographic information and clinical data needed for the model were gathered from a phase III treat-to-target clinical trial (NCT02762578) and other Chinese cohort studies. Medical costs on treating diabetes were calculated based on clinical trial and local sources. The diabetes management and complications costs were derived from published literature. A discounting rate of 5% was applied to both health and cost outcomes. And one-way and probabilistic sensitivity analyses were carried out to test the reliability of the results.
Compared with BIAsp 30, treatment with IDegAsp was associated with an incremental benefit of 0.001 LYs (12.439 vs. 12.438) and 0.280 QALYs (9.522 vs. 9.242) over a 30-year time horizon, and increased CNY (Chinese Yuan) 3,888 (390,152 vs. 386,264) for total costs. IDegAsp was cost-effective vs. BIAsp 30 therapy with an incremental cost-effectiveness ratio of CNY 13,886 per QALY gained. Results were robust across a range of sensitivity analyses.
Compared with BIAsp 30, IDegAsp was a cost-effective treatment option for people with T2DM with inadequate glycemic management on basal insulin in China.
评估德谷胰岛素/门冬胰岛素（IDegAsp）相较于双相门冬胰岛素 30（BIAsp 30）用于治疗中国血糖控制不佳的基础胰岛素治疗 2 型糖尿病（T2DM）患者的长期成本效果。
采用已发表和验证的 CORE（Outcomes Research 中心）糖尿病模型，从中国医疗保健系统的角度模拟疾病进展并计算 30 年内的总直接医疗成本、生命年（LY）和质量调整生命年（QALY）。模型所需的患者人口统计学信息和临床数据来自一项针对目标的 III 期临床试验（NCT02762578）和其他中国队列研究。根据临床试验和当地来源计算治疗糖尿病的医疗费用。糖尿病管理和并发症成本来自已发表的文献。对健康和成本结果应用了 5%的折扣率。并进行了单因素敏感性分析和概率敏感性分析，以检验结果的可靠性。
与 BIAsp 30 相比，在 30 年的时间内，IDegAsp 治疗与 0.001 LY（12.439 对 12.438）和 0.280 QALY（9.522 对 9.242）的增量获益相关，总费用增加了 3888 元（390152 对 386264）。IDegAsp 相对于 BIAsp 30 治疗的增量成本效果比为每获得一个 QALY 增加 3888 元。结果在一系列敏感性分析中是稳健的。
与 BIAsp 30 相比，IDegAsp 是中国血糖控制不佳的基础胰岛素治疗的 T2DM 患者的一种具有成本效果的治疗选择。
