Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Diabetes Obes Metab. 2024 Dec;26(12):5995-6006. doi: 10.1111/dom.15973. Epub 2024 Sep 30.
Insulin icodec is a first once-weekly administration basal insulin analogue for type 2 diabetes. This study aimed to investigate the price range of icodec for type 2 diabetes in the Chinese market, taking insulin degludec as reference.
Long-term health outcomes and costs for icodec and degludec were simulated using the United Kingdom Prospective Diabetes Study Outcomes Model (version 2.1) over 40 years from the Chinese healthcare provider's perspective. The efficacy and safety data were obtained from the ONWARDS 2 trial (Switching to once-weekly insulin icodec versus once-daily insulin degludec in individuals with basal insulin-treated type 2 diabetes (ONWARDS 2): a phase 3a, randomised, open label, multicentre, treat-to-target trial). Cost-utility analysis and a binary search were used to investigate the price range of icodec. Sensitivity analyses were performed to verify the robustness of the base-case analysis results.
After a 40-year simulation, the quality-adjusted life years (QALY) of icodec and degludec were 10.32 and 10.28 years, respectively. At the initial assumption of the same annual costs of icodec and degludec of $455.40, icodec was the dominant therapy compared with degludec, with higher QALYs and lower total cost. After the binary search, we observed that the annual cost range of icodec was $625.17-$855.25. This cost range was finally adjusted to be $597.66-$736.34 using one-way sensitivity analysis and confirmed using probabilistic sensitivity analysis and scenario analysis. The scenario analysis revealed that the annual cost range of icodec could be $506.70-$736.34 if the price of degludec decreased by 20% in the future.
Insulin icodec appears to be more cost effective than degludec if the annual cost of icodec ranges from $597.66 to $736.34 for patients with type 2 diabetes in China.
胰岛素icodec 是一种每周一次给药的基础胰岛素类似物，适用于 2 型糖尿病。本研究旨在调查中国市场上 icodec 用于 2 型糖尿病的价格范围，以胰岛素地特胰岛素为参照。
从中国医疗保健提供者的角度，使用英国前瞻性糖尿病研究结果模型（版本 2.1），对 icodec 和地特胰岛素在 40 年内的长期健康结果和成本进行模拟。疗效和安全性数据来自 ONWARDS 2 试验（在接受基础胰岛素治疗的 2 型糖尿病患者中，从每日一次胰岛素地特胰岛素转换为每周一次胰岛素 icodec 的 2 期、随机、开放标签、多中心、以目标为导向的试验（ONWARDS 2））。使用成本效用分析和二进制搜索来研究 icodec 的价格范围。进行敏感性分析以验证基础分析结果的稳健性。
经过 40 年的模拟，icodec 和地特胰岛素的质量调整生命年（QALY）分别为 10.32 年和 10.28 年。在 icodec 和地特胰岛素的初始假设年度成本相同的情况下（455.40 美元），icodec 与地特胰岛素相比是更优的治疗方法，因为它具有更高的 QALY 和更低的总成本。经过二进制搜索，我们观察到 icodec 的年度成本范围为 625.17-855.25 美元。使用单向敏感性分析将此成本范围调整为 597.66-736.34 美元，并通过概率敏感性分析和情景分析进行确认。情景分析显示，如果地特胰岛素的价格在未来降低 20%，icodec 的年度成本范围可能为 506.70-736.34 美元。
如果中国 2 型糖尿病患者的 icodec 年治疗费用在 597.66-736.34 美元之间，那么 icodec 似乎比地特胰岛素更具成本效益。
