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Journal of Diabetes & Metabolic Disorders

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08-04-2023 | Insulin Glargine | Research Article

Pharmacoeconomic evaluation of insulin aspart and glargine in type 1 and 2 diabetes mellitus in Iran

Authors: Marzieh Nosrati, Soroush Ahmadi Fariman, Parisa Saiyarsarai, Shekoufeh Nikfar

Published in: Journal of Diabetes & Metabolic Disorders | Issue 1/2023

Abstract

Purpose

The higher costs of insulin analogs including short-acting insulin aspart (IAsp) and long-acting insulin glargine (IGla) have restricted their widespread uptake despite having improved pharmacokinetic and pharmacodynamic properties and patient convenience. This study aims to evaluate the cost-effectiveness of IAsp versus Regular Insulin (RI) and IGla versus NPH Insulin in type 1 and 2 diabetes from the perspective of the Iranian healthcare system.

Methods

Clinical data including HbA1c levels, hypoglycemia, weight gain, and health-related quality of life were derived from the included systematic review and meta-analysis studies. Different methods of pharmacoeconomic evaluation were used for an annual time horizon. Utility decrements for diabetes-related complications were extracted from the literature. Direct medical costs were calculated in 2022 prices. A one-way sensitivity analysis was also performed.

Results

In type 1 diabetes, IAsp was associated with more costs and effects in terms of reducing HbA1c compared with RI. An incremental cost of $83 was estimated to obtain an additional 1% reduction in HbA1c per patient per year. Similarly, an incremental cost of $16 was estimated for IGla compared with NPH. In type 2 diabetes, IAsp and RI were associated with equal efficacy and safety. For IGla versus NPH, the incremental cost-effectiveness ratio was calculated at $1975 per quality-adjusted life-year. The robustness of the result was confirmed through sensitivity analysis.

Conclusion

Insulin analogs, IAsp and IGla, are cost-effective for type 1 diabetes versus human insulins, RI and NPH. For type 2 diabetes, IAsp is not cost-effective when compared with RI. For IGla versus NPH, however, the incremental cost-effectiveness ratio seems to be within the accepted thresholds.

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Title: Pharmacoeconomic evaluation of insulin aspart and glargine in type 1 and 2 diabetes mellitus in Iran
Authors: Marzieh Nosrati
Soroush Ahmadi Fariman
Parisa Saiyarsarai
Shekoufeh Nikfar
Publication date: 08-04-2023
Publisher: Springer International Publishing
Keywords: Insulin Glargine
Insulins
Hypoglycemia
Insulin Aspart
Diabetes
Insulins
Published in: Journal of Diabetes & Metabolic Disorders / Issue 1/2023
Electronic ISSN: 2251-6581
DOI: https://doi.org/10.1007/s40200-023-01209-1

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