The clinical effectiveness of insulin glargine in patients with Type I diabetes in Brazil: findings and implications.

Abstract

Published studies have challenged the cost-effectiveness of insulin glargine versus neutral protamine hagedorn (NPH) insulins in Brazil with limited evidence of increased effectiveness despite considerably higher acquisition costs. However, still a controversy. Consequently, there is a need to address this. Retrospective cohort study of Type I diabetes patients receiving insulin glargine in Brazil following NPH insulin who met the criteria. 580 patients were enrolled. HbA1c varied from 8.80±1.98% in NPH insulin users to 8.54±1.88% after insulin glargine for 6 months, which is not clinically significant. Frequency of glycemic control varied from 22.6% with NPH insulin to 26.2% with insulin glargine. No statistically significant difference was observed between controlled and still uncontrolled groups for all analyzed factors including type and frequency of insulin use and carbohydrate counting. Limited differences between NPH insulins and insulin analogs in routine clinical care do not justify an appreciable cost difference.