PDB55 - Cost Minimization Analysis of Insulin Glargine 300 U/Ml Vs Glargine 100 U/Ml for the Management of Type 2 Diabetes from A Private and Public Third-Party Payer Perspective in Chile

Abstract

Type 2 diabetes prevalence in Chile is estimated to be between 4.2% to 7.5% of the population. Approximately 4.3% of the population reports the use of diabetes medication with 0.64% reporting use of insulin. Long acting insulin analogs have contributed to disease management, with Insulin Glargine 100 U/mL having benefits on nocturnal and overall hypoglycemia compared to human NPH insulin. Research shows that Insuline Glargine 300 U/mL is an efficient and safe analog. We conducted a cost minimization analysis of these two analogs from the perspective of third-party payers of patients receiving services in both the public (FONASA) and private (ISAPRES) Chilean insurance systems, considering that both analogues sell for the same price. Information on safety and efficacy of both treatments was retrieved randomized trials comparing both types of insulin analogues and a published meta-analysis. Since there are no billing databases in Chile where costs of an episode of hypoglycemia could be identified, we used an expert panel methodology to estimate resource use for both severe and non-severe hypoglycemia episodes at home, as outpatient and inpatient, along with an estimation of their relative frequencies. Costs for every intervention and procedure were calculated from national billing databases and private insurer´s billing databases. Published comparisons of both analogues indicated similar efficacy and safety profiles, with a statistically significant difference in confirmed or severe hypoglycemic events at any time of day favoring Insuline Glargine 300 U/mL with 15.22 annualized events per subject compared to 17.73 annualized events per subject. Estimation of the difference in total cost of hypoglycemic episodes indicated a potential yearly cost saving for FONASA of US$ 95.65 per patient and US$ 153.61 for ISAPRES. Insuline Glargine 300 U/mL is potentially cost saving for third party-payers in Chile both in the private and public health system.