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Although economic analyses are subject to considerable uncertainty, the study supports recent NICE clinical guidelines that NPH should be the preferred first line choice of insulin in type 2 diabetes. This finding is driven by much the higher costs and limited clinical advantage of the comparators long acting insulin analogues glargine and detemir. Exenatide appeared clinically and cost effective as an alternative to starting insulin immediately on failure of oral therapy for glucose lowering. Sitagliptin and vildagliptin had similar clinical effectiveness as glitazone but this was achieved at lower cost and side effects
University of Aberdeen, Aberdeen, UK
* Corresponding author Email: n.r.waugh@abdn.ac.uk
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