A UK Analysis of the Cost-Effectiveness of Humalog Mix75/25 and Mix50/50 Versus Long-Acting Basal Insulin

Abstract

As healthcare spending on diabetes and its complications continues to rise, the optimization of prescribed insulin regimens is becoming increasingly important from both clinical and economic perspectives. The aim of the present study was to evaluate the cost-effectiveness of 75/25 biphasic insulin lispro and 50/50 biphasic insulin lispro (Humalog® Mix75/25 and Humalog® Mix50/50, respectively; Eli Lilly and Company, Indianapolis, IN, USA) compared with a long-acting analog insulin regimen in patients with type 2 diabetes. A published and validated computer simulation model of diabetes was used to evaluate the cost-effectiveness of 75/25 and 50/50 biphasic insulin lispro versus a long-acting analog insulin (insulin glargine) from the perspective of a healthcare payer in the UK. Treatment effects in terms of glycated hemoglobin (HbA1c) benefits were taken from a recent meta-analysis. Direct medical costs including pharmacy, complication, and patient management costs were obtained from published sources. All costs were expressed in 2008 British pounds sterling (GBP), and future costs and clinical benefits were discounted at 3.5% per annum. Sensitivity analyses were performed. 75/25 and 50/50 biphasic insulin lispro were associated with improvements in life expectancy of 0.09 and 0.13 years, respectively, improvements in quality-adjusted life expectancy of 0.09 quality-adjusted life years (QALYs) and 0.12 QALYs, respectively, and reductions in cost of GBP 1,217 and GBP 430, respectively, when compared with long-acting analog insulin. Based on a recently published meta-analysis, biphasic analog insulins are likely to improve clinical outcomes and reduce costs versus long-acting analog insulins in the longterm treatment of patients with type 2 diabetes in the UK.