Evaluating the cost-effectiveness of reduced mild hypoglycaemia in subjects with Type 1 diabetes treated with insulin detemir or NPH insulin in Denmark, Sweden, Finland and the Netherlands.
Diabet Med
; 29(3): 303-12, 2012 Mar.
Article
em En
| MEDLINE
| ID: mdl-21951030
ABSTRACT
AIMS:
To estimate short-term cost-effectiveness of insulin detemir vs. NPH insulin based on the incidence of mild hypoglycaemia in subjects with Type 1 diabetes in Denmark, Sweden, Finland and the Netherlands.METHODS:
A model was developed to evaluate cost-effectiveness based on mild (self-treated) hypoglycaemia and pharmacy costs over 1 year. Published rates of mild hypoglycaemia were used for NPH insulin and insulin detemir. Effectiveness was calculated in terms of quality-adjusted life expectancy. Pharmacy costs were accounted using published prices and defined daily doses for both insulins. Costs were expressed in 2010 euros ().RESULTS:
Treatment with insulin detemir was associated with fewer mild hypoglycaemic events than NPH insulin (mean rates of 26.3 vs. 35.5 events per person-year), leading to an improvement in mean quality-adjusted life expectancy of approximately 0.019 (0.030) quality-adjusted life years (standard deviation). Annual costs were 573.55 (110.42) vs. 332.76 (62.18) in Denmark for insulin detemir and NPH insulin, respectively. These values were 545.79 (106.54) vs. 306.12 (57.78) in Sweden, 720.10 (140.74) vs. 408.73 (78.61) in Finland and 584.01 (109.47) vs. 359.60 (64.84) in the Netherlands. Incremental cost-effectiveness ratios were approximately 12,644 (Denmark), 12,612 (Sweden), 16,568 (Finland) and 12,216 (the Netherlands) per quality-adjusted life year gained for insulin detemir vs. NPH insulin.CONCLUSIONS:
Insulin detemir is likely to be cost-effective vs. NPH insulin in subjects with Type 1 diabetes in Denmark, Sweden, Finland and the Netherlands. Increased pharmacy costs with insulin detemir should not be a barrier to therapy based on these findings.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Farmácias
/
Insulina de Ação Prolongada
/
Diabetes Mellitus Tipo 1
/
Hipoglicemia
/
Hipoglicemiantes
/
Insulina Isófana
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article