Análisis de costes del tratamiento de la diabetes mellitus tipo 2 con insulina glargina o detemir

Abstract

Introduction:Large published data suggested that some patients initiating with the recommended once daily insulin detemir administration require twice daily dosing to optimise blood glucose control. Therefore the clinical outcome in this selected population was tested in a randomized controlled trial. Objective:To compare the costs of two treatments of type 2 diabetes mellitus, insulin glargine and insulin detemir, in patients with type 2 diabetes not controlled with oral antidiabetic agents. Methods:Costs-offset analysis was modelled from the Spanish National Health System perspective, taking into account the health direct costs. A simulation of resources use related with glargine and detemir in type 2 diabetes treatment was performed, taking into account insulin administered doses, utilization of test strips for glycemia control and disposable needles used. The glargine and detemir doses were obtained from one clinical trial comparing both insulins for 24 weeks. The test strips and disposable needles use were estimated from the Spanish clinical practice. Unit costs were taken from Spanish sources and databases. Results:Lower daily doses were administered with glargine than with detemir. Therefore, the use of glargine instead detemir would result in a lower daily cost of insulin treatment, and a lower use of test strips and disposable needles. As a consequence, the glargine use would result in an annual saving of 765.03 € for a patient with type 2 diabetes, 43.3% savings with glargine versus detemir. According to the sensitivity analysis, the annual saving for a patient treated with glargine was between 646.05 and 810.55 €. Conclusions:According to this model, in the above mentioned population, glargine insulin is a more cost-effective treatment than detemir insulin, with lower annual treatment costs.