PDB45 EVALUATING THE SHORT-TERM COST-UTILITY OF INSULIN DEGLUDEC VERSUS INSULIN GLARGINE U100 IN BASAL-BOLUS REGIMENS FOR TYPE 2 DIABETES IN CHINA

Abstract

Insulin degludec (degludec) is an insulin analog with an ultra-long duration of action, low risk of hypoglycaemia and confirmed cardiovascular safety demonstrated in DEVOTE trial (NCT01959529). The study aimed to evaluate the short-term cost-utility of degludec versus insulin glargine 100 units/mL (glargine) for the treatment of type 2 diabetes (T2DM) receiving basal–bolus insulin therapy in China based on data from subgroup results of the DEVOTE trial. A short-term health economic model programmed in Microsoft Excel was conducted to compare costs in patients receiving once daily degludec or glargine over a 2-year time horizon. Clinical inputs and patient characteristics were taken exclusively from DEVOTE trial, whilst China-specific costs (the most current drug provincial biding price in china) were obtained from the literature. Both costs and health effects had not been discounted annually for such a short time horizon. Sensitivity analyses were conducted to assess the robustness of the results. Degludec was associated with a mean improvement of 0.00649 quality-adjusted life-years (QALYs) compared with glargine, with improvements driven predominantly by lower rates of severe hypoglycaemia with degludec versus glargine. degludec was associated with mean cost savings of 289.35 CNY per patient relative to glargine in patients with type 2 diabetes. Cost savings were primarily driven by the reduction in risk of diabetes-related complications with degludec, which offset the higher treatment costs relative to glargine. Insulin relative cost of degludec was 1040.36 CNY (16.98%) more than glargine. However, the costs of Non-fatal myocardial infarction, Non-fatal stroke, severe hypoglycaemia, and self-monitoring of blood glucose were reduced by 764.56 CNY (28.51%), 119.71 CNY (19.47%), 195.06 CNY (21.35%), and 210.13 CNY (36.94%), respectively. Sensitivity analyses demonstrated that the results were stable to variations in biding price. Among T2DM receiving basal–bolus insulin therapy in China, degludec is a cost saving treatment option compared with glargine.