Abstract
Second generation insulin analogue — insulin glargine 300 UI/ml (GLA-300) — can provide an effective control of Diabetes Mellitus (DM) with minimal risk of hypoglycemic events and prevent of cardiovascular complications or events (CVS). Pharmacoeconomic comparison of most used insulins — GLA-300 and detemir (IDet) has been based on indirect treatment comparison in DM Type 2. Materials and methods. Indirect treatment comparison was created according to published data of a real world evidence data for the treatment of DM Type 2 with GLA-300 and IDet, and common comparator — GLA-100 — has been used. Patients (%) who reached HbA1c target were indicated as an efficacy criteria. Odds ratios (OR) were calculated for clinical efficacy and severe hypoglycemia’s rate comparisons for GLA-300 and IDet. Direct (cost of annual treatment, hypoglycemia correction, CVS treatment), indirect medical costs as well as indirect costs (GDP loses) were calculated for GLA-300 and IDet strategies. Sensitivity analysis has been performed for confirmation of the base scenario results. Results. GLA-300 has advantages vs IDet by efficacy and less risks of severe hypoglycemia (OR 1.27 CI 95 % 1.02; 1.58 and OR 0.72 CI 95 % 0.56; 0.88 accordingly). Probability of good control of DM Type 2 (based on target of HbA1c<7.0 %) was higher on 27 % in GLA-300. Costs of insulins, expenditures for CVS treatment and payment for temporary disability were similar for GLA-300 and IDet groups (for the one-year treatment period), in the same time in GLA-300 group the less expenditures for hypoglycemia were observed. Total expenditures were slightly less for GLA-300 on 3.7 % vs IDet.Conclusion. GLA-300 and IDet have no economic advantages between groups in total costs, but GLA-300 has tended for economic benefi ts in compare with IDet in DM Type 2.
Highlights
1 — Non-profit organization “Scientific and Practical Centre for rational pharmaceutical management and pharmacoeconomics problems”, Russia, Moscow 2 — RUDN University, Russia, Moscow
GLA-300 and IDet have no economic advantages between groups in total costs, but GLA-300 has tended for economic benefits in compare with IDet in DM Type 2
У которых применяются инсулин гларгин 100 ЕД/мл и инсулин НПХ, различаются: несмотря на более высокую стоимость аналога инсулина, затраты на контроль сахарный диабет 2 типа (СД 2) оказываются в целом ниже, в том числе и за счёт меньшего числа гипогликемий [11]
Summary
GLA-300 and IDet have no economic advantages between groups in total costs, but GLA-300 has tended for economic benefits in compare with IDet in DM Type 2. В большей степени это относится к инсулину НПХ, частота симптоматических и тяжёлых гипогликемий при применении которого с целью эффективного (до цели) контроля заболевания выше в сравнении с инсулином гларгин 100 ЕД/мл в несколько раз [10]. У которых применяются инсулин гларгин 100 ЕД/мл и инсулин НПХ, различаются: несмотря на более высокую стоимость аналога инсулина (при сравнении стоимости ЕД активности), затраты на контроль СД 2 оказываются в целом ниже, в том числе и за счёт меньшего числа гипогликемий [11]. На этих примерах отчётливо прослеживается доказательство того, что низкая стоимость единицы активного вещества не должна быть определяющей в выборе препарата для лечения, поскольку более важно, сколько стоит добиться клинической эффективности (контроль СД 2), на какой срок и с какими нежелательными эффектами. Задачи: поиск литературы с целью изучения клинической эффективности инсулина гларгин 300 ЕД/мл и инсулина детемир при СД 2; непрямое сравнение клинической эффективности инсулина гларгин 300 ЕД/мл с инсулином детемир для контроля СД 2; оценить нагрузку на бюджет здравоохранения и бремя заболевания при применении сравниваемых препаратов при СД 2
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