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An analysis of the short- and long-term cost-effectiveness of starting biphasic insulin aspart 30 in insulin-naive people with poorly controlled type 2 diabetes

Lookup NU author(s): Emeritus Professor Philip Home



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Aim: This study aimed to assess the cost-effectiveness of starting insulin therapy with biphasic insulin aspart 30 (BIAsp 30) in people with type 2 diabetes inadequately controlled on oral glucose-lowering drugs in Saudi Arabia, India, Indonesia, and Algeria.Methods: The IMS CORE Diabetes Model was used to evaluate economic outcomes associated with starting BIAsp 30, using baseline characteristics and treatment outcomes from the A(1)chieve study. Time horizons of 1 and 30 years were applied, with country-specific costs for complications, therapies, and background mortality. Incremental cost-effectiveness ratios (ICERs) are expressed as cost per quality-adjusted life-year (QALY) in local currencies, USD, and fractions of local GDP per capita (GDPc). Cost-effectiveness was pre-defined using the World Health Organization definition of <3.0 times GDPc. Comprehensive sensitivity analyses were performed.Results: In the primary 30-year analyses, starting BIAsp 30 was associated with a projected increase in life expectancy of >1 year and was highly cost-effective, with ICERs of -0.03 (Saudi Arabia), 0.25 (India), 0.48 (India), 0.47 (Indonesia), and 0.46 (Algeria) GDPc/QALY. The relative risk of developing selected complications was reduced in all countries. Sensitivity analyses including cost of self-monitoring, treatment costs, and deterioration of glucose control with time showed the results to be robust. In a 1-year analysis, ICER per QALY gained was still cost-effective or highly cost-effective.Conclusion: Starting BIAsp 30 in people with type 2 diabetes in the A(1)chieve study was found to be cost-effective across all country settings at 1- and 30-year time horizons, and usefully increased predicted life expectancy. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Publication metadata

Author(s): Shafie AA, Gupta V, Baabbad R, Hammerby E, Home P

Publication type: Article

Publication status: Published

Journal: Diabetes Research and Clinical Practice

Year: 2014

Volume: 106

Issue: 2

Pages: 319-327

Print publication date: 01/11/2014

Online publication date: 16/09/2014

Acceptance date: 30/08/2014

Date deposited: 23/02/2015

ISSN (print): 0168-8227

ISSN (electronic): 1872-8227

Publisher: Elsevier


DOI: 10.1016/j.diabres.2014.08.024


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