Abstract
To estimate the budgetary impact of the introduction of Lilly (LY) IGlar for the treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in patients eligible for long-acting insulin analogs (LAIAs) from either a US commercial (COM) or Medicare (MED) payer perspective. A budget impact model (BIM) with a 5-year time horizon was developed to estimate the overall costs of introducing LY IGlar to hypothetical 1,000,000 member healthcare plans. The number of patients eligible for treatment with LAIAs, treatment mix, adverse events, and treatment costs were calculated from published sources and market research data. Patient prevalence and treatment dosages were assigned separately for T1DM and T2DM. Adverse events can be incorporated in optional analyses. One-way sensitivity analyses are used to identify the relative impact of each model input. For a hypothetical COM 1,000,000 member plan with 12,425 people using an LAIA in Year 1 (Y1), the introduction of LY IGlar alongside all comparators induced a cost-savings of $541,761 in Y1 ($0.045 per member per month [PMPM]), increasing to savings of $3,874,414 ($0.323 PMPM) in Y5 of the BIM. For a MED population of 1,000,000 individuals with 42,947 using an LAIA in Y1, total cost savings in Y1 were $1,872,989 ($0.156 PMPM) and increased to a savings of $13,385,785 ($1.116 PMPM) in Y5. The model was most sensitive to LY IGlar package costs, T2DM prevalence and T2DM LAIA usage. LY IGlar is found to be a cost-saving option upon introduction for healthcare plans both in COM and MED scenarios. If the relative costs of comparators stay the same and LY IGlar reaches a 20% share of the LAIA market, savings in the fifth year are projected to be over $0.32 PMPM and $1.11 PMPM for a 1,000,000 member COM or MED plan, respectively.
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